Wilkowska Alina, Wiglusz Mariusz S, Cubała Wiesław J
Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland.
Front Psychiatry. 2019 Jul 19;10:520. doi: 10.3389/fpsyt.2019.00520. eCollection 2019.
Bipolar disorder is associated with a high risk of suicide attempts and suicide deaths. The suicide mortality of people with bipolar disorder is approximately 25 times higher than the general population. No approved pharmacological strategies for suicidal thoughts and attempts in bipolar disorder have been introduced so far, and lithium remains as the first-line treatment for suicidal subjects. Clozapine is also a potentially good candidate for this indication. This case series represents three treatment-resistant bipolar patients with severe suicidal ideation who responded to low-dose clozapine treatment.
双相情感障碍与自杀未遂及自杀死亡的高风险相关。双相情感障碍患者的自杀死亡率约为普通人群的25倍。迄今为止,尚未推出针对双相情感障碍患者自杀念头和自杀未遂的获批药物治疗策略,锂盐仍然是自杀患者的一线治疗药物。氯氮平也是该适应症的潜在良好候选药物。本病例系列介绍了3例难治性双相情感障碍患者,他们有严重的自杀意念,对低剂量氯氮平治疗有反应。