Question: In patients with rapid (or ultra rapid) cycling bi-polar disorder how effective is clozapine compared to any other treatment in achieving a period of euthymic mood for sufficient time to allow discharge?

Answer:

No definite clinical implications can be made from the available evidence. Currently, there are no trials that evaluate the effectiveness of clozapine in comparison with other treatments exclusively in patients with rapid cycling bi-polar disorder. Evidence that address this BEST question is based on a subgroup analysis of a RCT - and in this analysis, only one outcome was evaluated (Brief Psychiatric Rating Scale). Study authors noted the need for further evidence-based research in this area, which would help develop more targeted treatments.