Atypical antipsychotics as enhancement therapy in rapid cycling mood states: a case study

Rapid cycling is not an uncommon occurrence in patients with bipolar affective disorder. This variant of the disease is notorious for its treatment resistance, in particular, lithium resistance. A full spectrum of cycloid mood states has been described. The author presents five cases in which the addition of atypical antipsychotics resulted in significant symptom relief. An argument for a preferential use of atypical antipsychotics, with their low risk of tardive dyskinesia, is made. General guidelines for the use of atypical antipsychotics in rapid cycling patients are discussed. Atypical antipsychotic medications in "cycloid disorders," including rapid cycling bipolar disease, are discussed.