New onset rapid cycling bipolar disorder in an 87 year old woman

New onset rapid cycling bipolar disorder is rare in late life. The authors report the case of an 87 year old woman who first developed this disorder at age 82 and was successfully treated with valproate and L-thyroxine. The contribution of aging, hypothyroidism and stroke to the etiology of this woman's disorder is discussed. The pharmacological management of rapid cycling bipolar disorder in the elderly is also reviewed.