The authors describe the first five patients enrolled in an open
clinical trial of clonazepam as a maintenance treatment in lithium-
refractory bipolar disorder. All patients relapsed quickly after taking
clonazepam (one within 2 weeks and four within 10-15 weeks), and the study
was prematurely terminated. The results cast doubt over the usefulness of
clonazepam as a prophylaxis in lithium-resistant bipolar patients who have
histories of psychotic mania or delusional depression.