Clozapine as an Off-Label Treatment for Severe and Treatment-Resistant (Auto-)Aggressive Behavior in a 40-Year-Old Patient With Mild Intellecutal Disability and Borderline Personality Disorder.

Q4 Medicine

Case Reports in Psychiatry Pub Date : 2026-01-31 eCollection Date: 2026-01-01 DOI:10.1155/crps/9991035

Lukas Zabel, Nathalie Ersek, Andreas B Hofmann, Lena Machetanz, Johannes Kirchebner, Susanne Stübner

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Abstract

Background: Clozapine has shown to be effective as an off-label treatment for aggressive behavior in patients with borderline personality disorder (BPD) and mild intellectual disability (MID). However, there is a lack of empirical evidence for its efficacy in these patient populations and results are so far heterogeneous.

Case presentation: A 40-year-old woman diagnosed with BPD and MID with severe and treatment-resistant aggressive behavior was treated off-label with clozapine. A carefully administered treatment with slow titration led to a significant reduction in self-aggressive behavior and termination of aggressive behavior towards others over a 26-week observation period.

Conclusions: Our case highlights the potential efficacy of clozapine as an off-label treatment for severe and treatment-resistant aggressive behavior in patients with combined BPD and MID. Clozapine should be considered as a therapeutic option in severe and complex cases.

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氯氮平对40岁轻度智力障碍和边缘型人格障碍患者行为的非严重和治疗抵抗性（自动）攻击标签治疗

背景：氯氮平已被证明是治疗边缘性人格障碍（BPD）和轻度智力残疾（MID）患者攻击行为的有效药物。然而，缺乏经验证据证明其在这些患者群体中的有效性，并且迄今为止结果是不一致的。病例介绍：一名40岁的女性被诊断为BPD和MID，并伴有严重和治疗抵抗性的攻击行为，她接受了氯氮平的治疗。在为期26周的观察期内，采用缓慢滴定的谨慎治疗显著减少了自我攻击行为，并终止了对他人的攻击行为。结论：我们的病例强调了氯氮平作为治疗BPD和MID合并患者严重和治疗抵抗性攻击行为的超说明书治疗的潜在疗效，氯氮平应该被考虑作为严重和复杂病例的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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