Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-14T22:32:31.717Z Has data issue: false hasContentIssue false
  • English
  • Français

Treatment options for rapid-cycling bipolar affective disorder

Published online by Cambridge University Press:  02 January 2018

David Taylor  and
Denise Duncan
Denise Duncan
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Rapid cycling (RC) occurs in up to 20% of patients with bipolar affective disorder and is particularly common in women. It is generally defined as a condition where four or more episodes of (hypo-) mania or depression occur in any year. Frequently, patients with RC switch rapidly between episodes without passing through a euthymic stage. RC is notoriously difficult to treat and the refractoriness of the condition has led to a number of drugs and combinations being put forward as potential therapeutic interventions. This article reviews current treatments and suggests a treatment strategy based on available evidence of efficacy and tolerability.

Type
Drug Information Quarterly
Information
Psychiatric Bulletin , Volume 20 , Issue 10 , October 1996 , pp. 601 - 603
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1996 The Royal College of Psychiatrists

References

Balfour, J. A. & Bryson, H. M. (1994) Valproic acid – a review of its pharmacology and therapeutic potential in indications other than epilepsy. CNS Drugs, 2, 144–173.Google Scholar
Bauer, M. S. & Whybrow, P. C. (1990) Rapid cycling bipolar affective disorder II. Treatment of refractory rapid cycling with high dose levothyroxine: a preliminary study. Archives of General Psychiatry, 47, 435–440.Google Scholar
Calabrese, J. R., Meltzer, H. Y. & Markovttz, P. J. (1991) Clozapine prophylaxis in rapid cycling bipolar disorder. Journal of Clinical Psychopharmacology, 11, 396–397.CrossRefGoogle ScholarPubMed
Calabrese, J. R., Meltzer, H. Y., Woyshville, M. J., Kimmel, S. E., et al (1993) Predictors of valproate response in bipolar rapid cycling. Journal of Clinical Psychopharmacology, 13, 280–283.Google Scholar
Calabrese, J. R., Meltzer, H. Y., Woyshville, M. J., Kimmel, S. E., et al (1995) A medication algorithm for treatment of bipolar rapid cycling? Journal of Clinical Psychiatry, 56(suppl 3), 11–18.Google Scholar
Dunner, D. L. & Fieve, R. R. (1974) Clinical factors in lithium carbonate prophylaxis failure. Archives of General Psychiatry, 30, 229–233.Google Scholar
Goodnick, P. J. (1995) Nimodipine treatment of rapid cycling bipolar disorder. Journal of Clinical Psychiatry, 56, 330.Google Scholar
Joyce, P. R. (1988) Carbamazepine in rapid cycling bipolar disorder. International Clinical Psychopharmacology, 3, 123–129.Google Scholar
Kramlinger, K. G. & Post, R. M. (1988) Adding lithium carbonate to carbamazepine: antimanic efficacy in treatment resistant-mania. Acta Psychiatrica Scandinavica, 79, 378–385.Google Scholar
McElroy, S. L., Keck, P.E. Jr, Pope, H. G. Jr, et al (1988) Valproate in the treatment of rapid cycling bipolar disorder. Journal of Clinical Psychopharmacology, 8, 275–279.CrossRefGoogle ScholarPubMed
Pazzagila, P. J., Post, R. M., Ketter, T. A., et al (1993) Preliminary controlled trial of nimodipine in ultra-rapid cycling affective dysregulation. Psychiatry Research, 49, 257–272.Google Scholar
Prien, R. F. & Gelenberg, A. J. (1989) Alternatives to lithium for preventive treatment of bipolar disorder. American Journal of Psychiatry, 146, 840–848.Google Scholar
Schaff, M. R., Fawcett, J. & Zajecka, J. M. (1993) Divalproex sodium in the treatment of refractory affective disorders. Journal of Clinical Psychiatry, 54, 380–384.Google Scholar
Shaw, D. M. (1988) Drug alternatives to lithium in manic-depressive disorders. Drugs, 36, 249–255.CrossRefGoogle ScholarPubMed
Small, J. G., Klapper, M. H., Milstein, V., et al (1991) Carbamazepine compared to lithium in the treatment of mania. Archives of General Psychiatry, 48, 915–921.Google Scholar
Suppes, T., Philips, K. A. & Judd, C. R. (1994) Clozapine treatment of nonpsychotic rapid cycling bipolar disorder: a report of three cases. Biological Psychiatry, 36, 338–340.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.