Rapid cycling in late-onset bipolar affective disorder predominantly mania

Bipolar affective disorder (BD) involves episodes of severe mood disturbance of depression and hypomania or mania and can result from the sensitization produced by repeated episodes. The authors present a case report assessed in the outpatient department of psychiatry of a tertiary care hospital in western Maharashtra. The patient was a 70-year-old female with late-onset rapid cycling bipolar affective disorder with predominantly hypomanic and manic episodes and co-morbidities of hypothyroidism, type II diabetes mellitus, and bullous pemphigoid. She was treated successfully with Tab quetiapine 400 mg/day, Tab lithium 600 mg/day, and Tab thyroxine 125 μg/day with a favorable response.