Bipolar Disorders: 2nd Stanley Symposium, Freiburg, November by J. Walden, H. Grunze

By J. Walden, H. Grunze

Complement factor: Neuropsychobiology 2002, Vol. forty five, Suppl. 1

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After the acute symptomatology had faded, we tried to replace haloperidol with risperidone to continue with the combination of valpraote and risperidone as maintenance treatment. However, another exacerbation of the manic and psychotic symptoms occurred. A trial with olanzapine was also unsuccessful, due to severe side effects (fatigue, depressive symptoms, difficulties to concentrate). We finally switched to a combination treatment of valproate 1,300 mg/day and clozapine 100 mg/day. During the titration phase, Ms.

Is a 34-year-old patient with bipolar I disorder. His first depressive episode with psychotic symptoms occurred at the age of 19. During the course of his illness, he had many very severe dysphoric manias, sometimes with mood-incongruent psychotic features that always led to hospitalization and which were mostly treated with the combination of lithium and carbamazepine as maintenance treatment and haloperidol in the acute phase. During the 3 years before he visited our outpatient clinic, he also received haloperidol as a maintenance treatment.

Even with the combination treatment of valproate and clozapine, Mr. R has lost 10 kg of weight since he stopped taking lithium, carbamazepine and haloperidol as maintenance treatment. He is also able to exercise, which he said he had not been able to do for years due to severe fatigue. Case 3 Ms. F. is a 23-year-old woman suffering from schizoaffective disorder. Besides her mood episodes, incongruent psychotic features like paranoid delusions and ideas of reference were the prominent symptoms, independently from mood deflections.

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