CLONIDINE MONOTHERAPY OF A PATIENT WITH MIXED BIPOLAR DISORDER AND MANIA - CHANGES IN SYMPTOMATOLOGY AND NEUROCHEMICAL VARIABLES

1. The authors report the effect of clonidine on one patient with mixe d bipolar disorder resistant to treatment with neuroleptics and antide pressants. The patient improved with a daily dose of 0.45 mg. 2. A man ic relapse of the patient, still on clonidine, was successfully treate d by increasing the clonidine dose to 0.6 mg per day. 3. During the tr eatment the main metabolites of norepinephrine 3-methoxy-4-hydroxyphen ylglycol (MHPG), of dopamine homovanillic acid (HVA) and of serotonin 5-hydroxy-indoleacetic acid (5-HIAA) were assessed in urine samples. P lasma GH and PRL levels were aslo estimated. 4. After initiation of cl onidine regimen MHPG and HVA excretion declined whereas 5-HIAA remaine d unaltered. The levels of all three metabolites showed a marked incre ase at the onset of a manic relapse and were reduced after the increas e of clonidine dose and the amelioration of manic symptoms. 5. Plasma GH and PRL levels did not exhibit any considerable changes.