Case reports in psychiatry · 2026
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.
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Zabel Lukas, Ersek Nathalie, Hofmann Andreas B, Machetanz Lena, Kirchebner Johannes, Stübner Susanne
Аннотация
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.
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.