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Valproic acid in ultra-rapid cycling: a case report
E Lepkifker1, I Iancu, P Dannon
1Department of Psychiatry B, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Clinical Neuropharmacology
|February 1, 1995
Summary
Valproic acid effectively treated ultra-rapid cycling bipolar disorder when added to lithium. This case study highlights valproate
Area of Science:
- Psychiatry
- Neuroscience
- Pharmacology
Background:
- Bipolar affective disorder (BAD) is a mood disorder characterized by shifts in mood, energy, and activity levels.
- Valproic acid is an established mood stabilizer, often used as an adjunctive treatment with lithium and carbamazepine for BAD.
- Rapid cycling bipolar disorder, defined as four or more mood episodes per year, presents a significant treatment challenge.
Observation:
- A male patient diagnosed with bipolar affective disorder experienced an extreme form of ultra-rapid cycling, with mood cycle durations as short as 48 hours.
- This ultra-rapid cycling pattern proved refractory to existing treatment regimens.
Findings:
- The addition of valproic acid (VPA) to the patient's ongoing lithium therapy was instrumental in controlling the ultra-rapid cycling.
- Valproic acid demonstrated significant efficacy in stabilizing the patient's extreme mood fluctuations.
Implications:
- This case suggests that valproic acid may be a valuable therapeutic option for managing ultra-rapid cycling bipolar disorder.
- Further research into the efficacy of valproic acid in severe and rapidly cycling forms of bipolar disorder is warranted.
- Understanding the mechanisms behind valproate's effectiveness in ultra-rapid cycling could inform future treatment strategies for complex bipolar disorder presentations.