Treatment of rapid-cycling bipolar disorder

Christopher D Schneck
Journal of Clinical Psychiatry 2006, 67 Suppl 11: 22-7
Rapid-cycling bipolar disorder is associated with poorer treatment response, poorer long-term prognosis, and probable higher suicide risk than bipolar disorder without rapid cycling. Patients with rapid cycling tend to experience more depressive than manic episodes, and the depressive episodes tend to be more refractory in nature compared with those in patients without rapid cycling. Results from studies of rapid cycling show that antidepressant use is most likely associated with the onset or worsening of rapid cycling. Controversy also exists as to whether rapid cycling is a transitory phenomenon in the course of bipolar illness or a more chronic condition better characterized as a subtype of the illness. Results from the first 500 patients with bipolar I or bipolar II disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study found an association between rapid cycling and depression and younger age at illness onset. Treatment involves a 3-part pathway to manage rapid cycling that includes reducing or stopping any possible cycle-promoting agents, adding or optimizing mood stabilizers, and using experimental or putative treatments for persistent rapid cycling after more traditional treatments have failed. Effective treatments for some patients with rapid-cycling bipolar disorder currently include lithium, divalproex, lamotrigine, carbamazepine, atypical antipsychotics, and psychosocial therapy.


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"