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Current concepts in rapid cycling bipolar disorder.
1Mood Disorders Program, Department of Psychiatry, Case Western Reserve University School of Medicine, 11400 Euclid Avenue, Suite 200, Cleveland, Ohio 44106, USA. mds6@po.cwru.edu
Current Psychiatry Reports
|December 21, 2000
Summary
Rapid-cycling bipolar disorder (RCBD) is difficult to treat and often diagnosed in women. More research is needed, but current evidence suggests using multiple mood stabilizers for effective management.
Area of Science:
- Psychiatry
- Neurology
Background:
- Rapid-cycling bipolar disorder (RCBD) lacks a consistent definition, with episode frequency varying widely.
- RCBD is disproportionately diagnosed in women with bipolar II disorder.
- Onset can occur in childhood, adolescence, or adulthood.
Purpose of the Study:
- To review the current understanding and treatment of rapid-cycling bipolar disorder.
- To highlight the need for controlled trials in homogeneous RCBD patient cohorts.
Main Methods:
- Literature review of existing studies on RCBD.
- Analysis of current treatment guidelines and preliminary data.
Main Results:
- RCBD appears treatment-refractory, though controlled trials are scarce.
- Current treatment often involves lithium and antiepileptic drugs, with antidepressants discouraged.
- Preliminary findings suggest a need for at least two mood stabilizers for adequate control.
Conclusions:
- Controlled trials in well-defined RCBD populations are essential.
- Combination mood stabilizer therapy may be necessary for effective RCBD management.