A partial solved issues in the treatment of Bipolar Disorder (BD) is depressive episode if is rapid cycling. Often, antidepressant monotherapy increases the risk of switching into mania/hypomania. Using quetiapine XR in these cases may help to avoid these disease burdens.

To estimate the clinical efficacy and acceptability, in rapid cycling depressive episode of quetiapine XR.

34 yrs. woman, Bipolar Disorder-Depressive Episode, rapid cycling (DSM-IV), scores YMRS=10 and HAMD-17=32 at baseline.

Depression (HAMD-17), mania (YMRS), CGI-S, CGI-I, side effects and relapse (follow-up: 12 month). The patient has a history of 12 yrs. of BD with 5 depressive and 6 manic episodes. Last year depressive episodes were 3 manic and 1 depressive episodes.

After 4 weeks, of treatment with quetiapine XR 300mg/day in the evening, the depressive scores improved 75%, sleep became normal, no co-medication was needed. The patient continued to receive quetiapine XR and assessments were performed monthly. The follow-up priod demonstrated no relapses (depressive or manic).

1. In this case of Bipolar Disorder-rapid cycling, the treatment of depressive episode quetiapine XR-300mg/day was effective and well tolerated; no switch in manic or hippomanic was noticed.