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Rapid cycling bipolar disorder in adults: Treatment of major depression

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 may be as effective as other drugs for rapid cycling [4].

This topic reviews the treatment of major depression in rapid cycling patients. The treatment of mania and hypomania in rapid cycling patients, and the epidemiology, pathogenesis, clinical features, and diagnosis of rapid cycling in patients with bipolar disorder are discussed separately, as is the diagnosis and general treatment of bipolar disorder:

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

(See "Rapid cycling bipolar disorder: Epidemiology, pathogenesis, clinical features, and diagnosis".)

(See "Bipolar disorder in adults: Assessment and diagnosis", section on 'Diagnosis'.)

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Literature review current through: Dec 2017. | This topic last updated: Jul 06, 2016.
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