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Rapid cycling bipolar disorder: Epidemiology, pathogenesis, clinical features, and diagnosis

Ralph Kupka, MD, PhD
Section Editor
Paul Keck, MD
Deputy Editor
David Solomon, MD


Bipolar disorder is characterized by mood episodes that are nearly always recurrent [1,2]. Patients who experience at least four episodes during a 12-month period are classified as “rapid cycling” [2]. The term was first used in 1974 to describe bipolar patients who were unresponsive to lithium [3]. However, it is now clear that pharmacotherapy is often less beneficial for rapid cycling patients than non-rapid cycling patients, and that lithium is not the least effective drug for rapid cycling [4].

This topic reviews the epidemiology, pathogenesis, clinical features, and diagnosis of rapid cycling in patients with bipolar disorder. Treatment of rapid cycling is discussed separately, as is the diagnosis and general treatment of bipolar disorder:

(See "Rapid cycling bipolar disorder in adults: Treatment of major depression".)

(See "Rapid cycling bipolar disorder in adults: Treatment of mania and hypomania".)

(See "Bipolar disorder in adults: Epidemiology and pathogenesis".)


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Literature review current through: Sep 2016. | This topic last updated: Oct 25, 2015.
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