Rapid-cycling bipolar disorder

doi:10.1017/CBO9780511544019.004

3 - Rapid-cycling bipolar disorder

Published online by Cambridge University Press: 10 August 2009

Omar Elhaj and

Joseph R. Calabrese

Edited by

Andreas Marneros and

Frederick Goodwin

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Omar Elhaj: Affiliation:
Case Western Reserve University, University Hospitals of Cleveland, Cleveland, OH, USA
Joseph R. Calabrese: Affiliation:
Case Western Reserve School of Medicine and University Hospitals of Cleveland, Cleveland, OH, USA
Andreas Marneros: Affiliation:
Martin Luther-Universität Halle-Wittenburg, Germany
Frederick Goodwin: Affiliation:
George Washington University, Washington DC

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Summary

Introduction

Since the Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV: American Psychiatric Association, 1994) recognized the existence of rapid cycling as a specific pattern of presentation, there has been increased interest in studying this treatment-refractory variant of bipolar disorder (Bauer et al., 1994). Prior to recent years, only open naturalistic studies had been conducted on populations of patients with rapid-cycling bipolar disorder. More recent data have suggested that this variant of illness is not always refractory to conventional treatment (Baldessarini, et al., 2000). In particular, the data suggest that the management of hypomania and mania accompanying this variant of illness is uncomplicated and that lithium is frequently quite effective in managing this phase of the illness (Dunner et al., 1976). However, it is now recognized that it is the management of the depressed phase that poses the greatest challenge to our pharmacotherapeutic armamentarium (Calabrese et al., 2001). The frequent recurrence of treatment-refractory depression is emerging as the greatest unmet need in the clinical management of patients with rapid-cycling bipolar disorder, and particularly those comorbid presentations with alcohol and drug abuse (Ketter and Calabrese, 2002). What follows is an update of the research conducted in the past 2 years that has aimed to clarify different aspects of rapid-cycling bipolar disorder, refine the tools of its diagnosis and management, and discover new pharmacotherapeutic interventions and strategies.

In a chapter of the “preceding book” (Marneros and Angst, 2000) Bipolar Disorders. 100 Years After Manic-Depressive Insanity, we gave an extensive overview of many aspects of rapid cycling (Calabrese et al., 2000a).

Keywords

comorbidity divalproex sodium genetic abnormalities lithium rapid-cycling bipolar disorder treatment-refractory depression mood disorders olanzapine

Information

Type: Chapter
Information: Bipolar Disorders
Mixed States, Rapid Cycling and Atypical Forms
, pp. 61 - 87
DOI: https://doi.org/10.1017/CBO9780511544019.004 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2005

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