Published online by Cambridge University Press: 13 June 2014
In the present work the author presents a literature update regarding the pharmacotherapeutic management of rapid cycling affective disorder. This phenomenon is characterized, according to Dunner and Fieve (1974), by the presence of at least four affective episodes per year. After a consideration of the clinical features of the disorder, which are in many respects similar to those of the ‘classic’ bipolar disorder, the author describes the different therapeutic strategies available to the psychiatrist. Withdrawal of antidepressant therapy and administration of lithium salts are likely to constitute the best initial approach. In case of treatment non-responsiveness, it is possible to consider the use of different drugs; for example, carbamazepine, sodium valproate, clorgyline, thyroid hormone. To date, the therapeutic management of rapid cyclers remains extremely difficult. Further studies, especially addressed to the aetiopathogenetic aspects of the disorder, are required.