Clozapine is a sedative and antipsychotic agent used in the treatment of schizophrenia. It was an important case to Psychotic Depressionunderline the limited evidence in using clozapine in a patient with severe refractory depression. A case study using the Evidence Based Medicine approach have performed and have attempted to work through this problem, according to an article of Annals of General Psychiatry Journals.

The authors of the article used an example of an in-patient with severe refractory psychotic depression who had been resistant to treatment with a combination of antidepressant, antipsychotics, mood stabiliser, and concomitant ECT therapy.

The patient had required one-to-one nursing on one admission because of self-harming behaviour, which included cutting and trying to set herself on fire. She is a 39-year-old married housewife with 2 children aged 16 and 12 years was electively admitted for treatment of worsening depression. The depressive symptoms followed soon after a triggering event of a horse-riding accident from which she suffered concussion, she had been receiving ECT treatment twice weekly and her medication was: Lithium carbonate 1000 mg once daily, Mirtazapine 60 mg at night, Olanzapine 20 mg at night, Chlorpromazine 50 mg at night as described in this article.

Premkumar Jeyapaul from Wimborne and Purbeck community mental health team, Canford Magna, Wimborne, Dorset, UK and Ray Vieweg from The Beeches, St James Hospital, Portsmouth, Hampshire, UK undertook a literature search for the use of clozapine in a patient with severe refractory depression. They had already tried the patient on a variety of medical treatments, which had limited benefit and started to formulate an Evidence Based Medicine question about is the use of clozapine and an antidepressant more beneficial than standard treatments for psychotic depression, in improving mood and psychotic symptoms.

In their conclussion they stated that there remains much uncertainty and would support further research in order to give more than a reserved and qualified affirmation but in this case clozapine made a significant improvement in clinical state. There were many uncontrolled factors that could have contributed to the overall improvement but in this patient the resistance to all previous treatments suggests that clozapine use was responsible for the improvement.

Find more about Psychotic Depression Treatment in Association with Clozapin Use in complete article read. Six pages of 220 Kb provided in PDF Format type (source: annals-general-psychiatry.com).