Antipsychotic agents, such as @entity1088 and @entity1090 , have been reported to be beneficial in the treatment of some @entity162 @entity1 . Many @entity162 @entity1 experience 'breakthrough episodes' of @entity1316 , with @entity162 or @entity308 recurring despite adequate ongoing levels of one or more mood-stabilizing medications. There are no controlled studies of breakthrough episodes, and there is little open experience to guide clinicians in pharmacotherapy of breakthrough episodes. This report describes the outcome of adjunctive @entity1090 treatment in breakthrough episodes of @entity162 . We assessed the outcome of openly adding @entity1090 to the medication regimen of 12 outpatients with @entity162 , type I, who suffered breakthrough episodes despite adequate maintenance medication ( @entity1091 , @entity1092 , or @entity2049 , or a combination of these). Prospective ratings were made at each clinical visit using the Clinical Global Impressions and Global Assessment of Functioning scales. @entity1 received @entity1090 for a mean of 6.0 months (23.96 weeks, range 0.5-72 weeks) at a mean dose of 2.75 mg/day (range 1-4.5 mg/day). Four @entity1 discontinued medication (two because of lack of efficacy at weeks 6 and 64, and two because of adverse events at weeks 0.5 and 23). Among the remaining eight @entity1 , four experienced a 10-25 point improvement in Global Assessment of Functioning scores and were rated much better on the Clinical Global Impression-Improvement scale. Although one @entity1 suffered a major @entity308 (at week 22), no @entity1 experienced worsening of @entity162 . This small open series suggests a subgroup of @entity162 @entity1 with breakthrough episodes may benefit from treatment with @entity1090 .

Long-term @entity1090 treatment in XXXX : 6-month follow up.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1088 :: ('MESH:D003024', 'Chemical') :: ['clozapine'] @entity162 :: ('MESH:D001714', 'Disease') :: ['bipolar disorder', 'mania', 'bipolar'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depressive recurrence', 'depression'] @entity1092 :: ('MESH:D014635', 'Chemical') :: ['valproate'] @entity1316 :: ('MESH:D019964', 'Disease') :: ['mood disorder'] @entity1091 :: ('MESH:D008094', 'Chemical') :: ['lithium'] @entity2049 :: ('MESH:D002220', 'Chemical') :: ['carbamazepine'] @entity1090 :: ('MESH:D018967', 'Chemical') :: ['risperidone']
@entity162 :: (MESH:D001714,Disease) :: ['bipolar disorder']
