Chapter 25. Rapid Cycling Bipolar Disorder: Phenomenology and Treatment

  1. Lakshmi N. Yatham3 and
  2. Mario Maj4
  1. Joseph F. Goldberg1 and
  2. Michael Berk2

Published Online: 13 AUG 2010

DOI: 10.1002/9780470661277.ch25

Bipolar Disorder

Bipolar Disorder

How to Cite

Goldberg, J. F. and Berk, M. (2010) Rapid Cycling Bipolar Disorder: Phenomenology and Treatment, in Bipolar Disorder (eds L. N. Yatham and M. Maj), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470661277.ch25

Editor Information

  1. 3

    Department of Psychiatry, The University of British Columbia, Vancouver, Canada

  2. 4

    Department of Psychiatry, University of Naples SUN, Naples, Italy

Author Information

  1. 1

    Mount Sinai School of Medicine, New York, NY, USA

  2. 2

    Barwon Health and the Geelong Clinic, University of Melbourne, Kitchener House, Ryrie Street, Geelong, Victoria 3220, Australia

Publication History

  1. Published Online: 13 AUG 2010
  2. Published Print: 1 OCT 2010

ISBN Information

Print ISBN: 9780470721988

Online ISBN: 9780470661277



  • rapid cycling bipolar disorder - phenomenology and treatment;
  • antidepressants and rapid cycling;
  • rapid cycling bipolar disorder;
  • anti-cycling agents, both the safest and most effective biological therapies - for rapid cycling;
  • carbamazepine for bipolar mania - conducted by Okuma and colleagues in Japan;
  • cycle length reduction, an accepted metric of impact of therapy on cycle change;
  • suprametabolic doses of thyroid hormone - for treatment of refractory rapid cycling;
  • L-type dihydropyridine calcium channel blocker and anticonvulsant nimodipine - reduction in cycling frequency in bipolar disorder patients;
  • two-year open-label trial of chromium - reported in rapid cycling individuals;
  • rapid cycling, common in women - linking reproductive health and menstrual cycle, not fully demonstrated


This chapter contains sections titled:

  • Controversies regarding the definition of rapid cycling

  • Phenomenology

  • Antidepressants and rapid cycling

  • Treatment of rapid cycling

  • Lithium and divalproex

  • Carbamazepine

  • Lamotrigine

  • Thyroid hormone

  • Calcium channel blockers

  • Second-generation antipsychotics

  • Is there a role for antidepressants?

  • Electroconvulsive therapy

  • Other novel treatments

  • Chronobiological treatments

  • Psychotherapy

  • Summary and conclusions

  • References