Low-dose maintenance clozapine treatment in the prophylaxis of bipolar affective disorder.

A chronically relapsing middle-aged man with bipolar affective disorder responded poorly to different forms of conventional pharmacotherapy, including depot antipsychotic medication and lithium. The addition of clozapine to lithium, even at doses as low as 25mg/day, led to a stabilisation of his mood. The withdrawal of low-dose clozapine led to a relapse within a few days. It is concluded that maintenance low-dose clozapine should be considered in bipolar disorders resistant to other treatments.