Clonazepam augmentation of antidepressants: does it distinguish unipolar from bipolar depression?

Background: The authors compared the effect of clonazepam supplement treatment on unipolar depression and bipolar depression. Methods: A total of 38 protracted depression patients with unipolar depression ( n=19) or bipolar depression ( n=19) were treated with 3.0 mg clonazepam for 4 weeks. Results: In the unipolar depression group, 84.2% of the subjects fulfilled the response criteria (at least an 80% reduction in their HDRS score). However, in the bipolar depression group, only 10.5% of them fulfilled these criteria. Conclusions: The difference in responses between the two groups supposes that the underlying abnormality in unipolar depression is not the same as that in bipolar depression. This trial also supposed that clonazepam can play active role in the treatment of protracted depression in patients with unipolar depression. Limitations: This finding was made in an open study, and the effect on clonazepam alone was not established.