Skip to main content
×
×
Home

Treatment options for rapid-cycling bipolar affective disorder

  • David Taylor and Denise Duncan (a1)
Extract

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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Treatment options for rapid-cycling bipolar affective disorder
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Treatment options for rapid-cycling bipolar affective disorder
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Treatment options for rapid-cycling bipolar affective disorder
      Available formats
      ×
Copyright
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.
Corresponding author
Correspondence
References
Hide All
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, 144173.
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, 435440.
Calabrese, J. R., Meltzer, H. Y. & Markovttz, P. J. (1991) Clozapine prophylaxis in rapid cycling bipolar disorder. Journal of Clinical Psychopharmacology, 11, 396397.
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, 280283.
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), 1118.
Dunner, D. L. & Fieve, R. R. (1974) Clinical factors in lithium carbonate prophylaxis failure. Archives of General Psychiatry, 30, 229233.
Goodnick, P. J. (1995) Nimodipine treatment of rapid cycling bipolar disorder. Journal of Clinical Psychiatry, 56, 330.
Joyce, P. R. (1988) Carbamazepine in rapid cycling bipolar disorder. International Clinical Psychopharmacology, 3, 123129.
Kramlinger, K. G. & Post, R. M. (1988) Adding lithium carbonate to carbamazepine: antimanic efficacy in treatment resistant-mania. Acta Psychiatrica Scandinavica, 79, 378385.
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, 275279.
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, 257272.
Prien, R. F. & Gelenberg, A. J. (1989) Alternatives to lithium for preventive treatment of bipolar disorder. American Journal of Psychiatry, 146, 840848.
Schaff, M. R., Fawcett, J. & Zajecka, J. M. (1993) Divalproex sodium in the treatment of refractory affective disorders. Journal of Clinical Psychiatry, 54, 380384.
Shaw, D. M. (1988) Drug alternatives to lithium in manic-depressive disorders. Drugs, 36, 249255.
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, 915921.
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, 338340.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 8 *
Loading metrics...

Abstract views

Total abstract views: 20 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 19th July 2018. This data will be updated every 24 hours.

Treatment options for rapid-cycling bipolar affective disorder

  • David Taylor and Denise Duncan (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *