Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T19:12:33.680Z Has data issue: false hasContentIssue false

Rapid cycling mood disorder: A review

Published online by Cambridge University Press:  13 June 2014

Patrick McKeon
Affiliation:
Depression Research Unit, St Patrick's Hospital, James's St, Dublin 8, Ireland

Abstract

Objectives: Rapid cycling mood disorder is an important clinical phenomenon. The concept of rapid cycling has evolved since it was first described in 1974. The purpose of this review is to summarise current diagnostic criteria, postulated risk factors and suggested management strategies.

Method: A Medline and Psych-Lit computerised literature search was supplemented by tracing back through the references from existing review work.

Results: Over 80 papers were identified which discussed diagnosis and management of rapid cycling.

Conclusions: DSM-IV provides a useful but narrow definition of rapid cycling. Standard treatment of affective disorder may exacerbate rapid cycling. If a rapid cycling course develops, discontinuation of antidepressants and use of mood stabilisers is recommended.

Type
Reviews
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Dunner, DL, Fieve, RR. Clinical factors in lithium carbonate prophylaxis failure. Arch Gen Psychiatry 1974; 30: 229–33.CrossRefGoogle ScholarPubMed
2.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed, (DSM-IV). Washington DC: American Psychiatric Association, 1994.Google Scholar
3.Kukopulos, A, Caliari, B, Tundo, A, et al.Rapid Cyclers, temperament, and antidepressants. Compr Psychiatry 1983; 24(3): 249–58.CrossRefGoogle ScholarPubMed
4.Wehr, TA, Sack, DA, Rosenthal, NE, Cowdry, RW. Rapid cycling affective disorder: contributing factors and treatment responses in 51 Patients. Am J Psychiatry 1988; 145: 179–84.Google ScholarPubMed
5.Coryell, W, Endicott, J, Keller, M. Rapidly cycling affective disorder: demographics, diagnosis, family history, and course. Arch Gen Psychiatry 1992; 49: 126–31.CrossRefGoogle ScholarPubMed
6.Alarcon, RD. Rapid cycling affective disorder: A clinical review. Compr Psychiatry 1985; 26(6): 522–40.CrossRefGoogle ScholarPubMed
7.Leibenluft, E, Clark, CH, Myers, FS. The reproducibility of depressive and hypomanic symptoms across repeated episodes in patients with rapid cycling bipolar disorder. J Affect Disord 1995; 33: 83–8.CrossRefGoogle ScholarPubMed
8.Bauer, MS, Whybrow, PC. Rapid cycling bipolar affective disorder. II. Treatment of refractory rapid cycling with high-dose levothyroxine: a preliminary study. Arch Gen Psychiatry 1990; 47: 435–40.CrossRefGoogle ScholarPubMed
9.Geller, B, Sun, K, Kimerman, B, Luby, J, Frazier, J, Williams, M. Complex and rapid-cycling in bipolar children and adolescents: a preliminary study. J Affect Disord 1995; 34: 259–68.CrossRefGoogle ScholarPubMed
10.Bauer, MS, Calabrese, J, Dunner, DL, Post, R, Whybrow, PC, Gyulai, Let al.Multi-site data reanalysis of the validity of rapid cycling as a course modifier for bipolar disorder in DSM-IV. Am J Psychiatry 1994; 151(4): 506–15.Google Scholar
11.Wolpert, EA, Goldberg, JF, Harrow, M. Rapid cycling in unipolar and bipolar affective disorders. Am J Psychiatry 1990; 147: 725–8.Google ScholarPubMed
12.Gellenberg, AJ, Klerman, GL, Hartmann, ELet al.Recurrent unipolar depressions with a 48-hour cycle: report of a case. Br J Psychiatry 1978; 133:123–9.CrossRefGoogle Scholar
13.Kramlinger, KG, Post, RM. Ultra-rapid and ultradian cycling in bipolar affective illness. Br J Psychiatry 1996; 168: 314–23.CrossRefGoogle ScholarPubMed
14.Goodwin, FK, Jamison, KR. Manic-depressive illness. New York: Oxford University Press, 1990.Google Scholar
15.Cowdry, RW, Wehr, TA, Zis, AP, Goodwin, FK. Thyroid abnormalities associated with rapid-cycling bipolar illness. Arch Gen Psychiatry 1983; 40: 414–20.CrossRefGoogle ScholarPubMed
16.Pincus, HA, Frances, A, Davis, WW, First, MB, Widiger, TA. DSM-IV and new diagnostic categories: holding the line on proliferation. Am J Psychiatry 1992; 149:112–7.Google ScholarPubMed
17.Post, RM, Ketter, TA, Pazzaglia, PJ, George, MS, Marangell, L, Denicoff, K. New developments in the use of anticonvulsants as mood stablisers. Neuropsychobiology 1993; 27: 132–7.CrossRefGoogle Scholar
18.Hurowitz, GI, Liebowitz, MR. Antidepressant-induced rapid cycling: six case reports. J Clin Psychopharmacol 1993; 13(1): 52–6.CrossRefGoogle ScholarPubMed
19.Lish, J, Gyulai, L, Resnick, SM, et al.A family history study of rapid-cycling bipolar disorder. Psychiatry Res 1993; 48: 3745.CrossRefGoogle ScholarPubMed
20.Leibenluft, E. Women with bipolar illness: clinical and research issues. Am J Psychiatry 1996; 153(2): 163–73.Google ScholarPubMed
21.MacKenzie, TB, Wilcox, K, Baron, H. Lifetime prevalence of psychiatric disorders in women with perimenstrual difficulties. J Affect Disord 1986; 10: 15–9.CrossRefGoogle ScholarPubMed
22.Oppenheim, G. A case of rapid mood cycling with oestrogen: implications for therapy. J Clin Psychiatry 1984; 45: 34–5.Google ScholarPubMed
23.Stancer, HC, Persad, E. Treatment of intractable rapid-cycling manic depressive disorder with levothyroxine. Arch Gen Psychiatry 1982; 39: 311–2.CrossRefGoogle ScholarPubMed
24.Morin, L. Fitzgerald, K, Ziicker, I. Estradiol shortens the period of hamster circadian rhythms. Science 1977; 196: 305–6.CrossRefGoogle ScholarPubMed
25.Bauer, MS, Whybrow, PC, Winokur, A. Rapid cycling bipolar affective disorder. I. Association with grade I hypothyroidism. Arch Gen Psychiatry 1990; 47: 427–32.CrossRefGoogle ScholarPubMed
26.Cho, JT, Bone, S, Dunner, DL, Colt, E, Fieve, RR. The effect of lithium treatment on thyroid function in patients with primary affective disorder. Am J Psychiatry 1979; 136: 115–6.Google ScholarPubMed
27.Whybrow, PC, Bauer, MS, Gyulai, L. Thyroid axis considerations in patients with rapid cycling affective disorder. Clin Neuropharmacol 1992; 15(1): 391A–2A.CrossRefGoogle ScholarPubMed
28.McKeon, P, Manley, P, Swanwick, G. Manic-depressive illness-I: clinical characteristics of bipolar disorder subtypes. Ir J Psychol Med 1992; 9: 69.CrossRefGoogle Scholar
29.Wehr, TA, Goodwin, FK. Rapid cycling in manic depressives induced by tricyclic antidepressants. Arch Gen Psychiatry 1979; 36: 555–9.CrossRefGoogle ScholarPubMed
30.Altshuler, LL, Post, RM, Leverich, GS, Mikalauskas, K, Roschoff, A, Ackerman, L. Antidepressant-induced mania and cycle acceleration: a controversy revisited. Am J Psychiatry 1995; 152: 1130–8.Google ScholarPubMed
31.Kellner, CH, Davenport, Y, Post, RM, Ross, RJ. Rapidly cycling bipolar disorder and multiple sclerosis. Am J Psychiatry 1984; 141: 112–3.Google ScholarPubMed
32.Walbridge, DG. Rapid cycling disorder in association with cerebral sarcoidosis. Br J Psychiatry 1990; 157: 611–3.CrossRefGoogle ScholarPubMed
33.McLoughlin, D, McKeon, P. Bipolar disorder and cerebral sarcoidosis. Br J Psychiatry 1991; 158: 410–3.CrossRefGoogle ScholarPubMed
34.Schaff, MR, Fawcett, J, Zajecka, JM. Divalproex sodium in the treatment of refractory affective disorders. J Clin Psychiatry 1993; 54: 380–4.Google ScholarPubMed
35.Joyce, PR. Carbamazepine in rapid cycling bipolar affective disorder. Int Clin Psychopharmacol 1988; 3: 2735.CrossRefGoogle ScholarPubMed
36.Sharma, V, Persad, E, Mazmanian, D, Karunaratne, K. Treatment of rapid cycling bipolar disorder with combination therapy of valproate and lithium. Can J Psychiatry 1993; 38: 137–9.CrossRefGoogle ScholarPubMed
37.Pazzaglia, PJ, Post, RM, Ketter, TA, George, MS, Marangell, LB. Preliminary controlled trial of nimodipine in ultra-rapid cycling affective dysregulation. Psychiatry Res 1993; 49(3): 257–72.CrossRefGoogle ScholarPubMed
38.Dunner, DL, Vijayalakshmy, P, Fieve, RR. Rapid cycling manic depressive patients. Compr Psychiatry 1977; 18(6): 561–6.CrossRefGoogle ScholarPubMed
39.Kukopulos, A, Reginaldi, D, Laddomada, Pel al.Course of the manic depressive cycle and changes caused by treatment. Pharmacopsychiatry 1980; 13: 156–67.CrossRefGoogle ScholarPubMed
40.McKeon, P, Manley, P, Swanwick, G. Manic depressive illness-II: treatment outcome in bipolar subtypes. Ir J Psych Med 1992; 9: 912.CrossRefGoogle Scholar
41.Post, RW, Uhde, TW, Roy-Byrne, PP, Joffe, RT. Correlates of antimanic responses to carbamazepine. Psychiatry Res 1987; 21: 7183.CrossRefGoogle ScholarPubMed
42.Ballenger, J. The clinical use of carbamazepine in affective disorders. J Clin Psychiatry 1988; 49(suppl): 1319.Google ScholarPubMed
43.Calabrese, JR, Woyshville, MJ. A Medication Algorithm for Treatment of Bipolar Rapid Cycling? J Clin Psychiatry 1995; 56(3): 11–8.Google ScholarPubMed
44.Okuma, T. Effects of carbamazepine and lithium on affective disorders. Neuropsychobiology 1993; 27: 138–45.CrossRefGoogle ScholarPubMed
45.Guscott, R. Clinical experience with valproic acid in 22 patients with refractory bipolar mood disorder. Can J Psychiatry 1992; 37(8): 590.CrossRefGoogle ScholarPubMed
46.Bowden, CL, Brugger, AM, Swann, AC, et al.Efficacy of divalproex vs. lithium and placebo in the treatment of mania. JAMA 1994; 271: 918–24.CrossRefGoogle ScholarPubMed
47.Calabrese, JR, Delucchi, GA. Spectrum of efficacy of valproate in 55 patients with rapid cycling bipolar disorder. Am J Psychiatry 1990; 147: 431–4.Google ScholarPubMed
48.Calabrese, JR, Woyshville, MJ, Kimmel, SE. Predictors of valproate response in bipolar rapid cycling. J Clin Psychopharmacol 1993; 13: 280–3.CrossRefGoogle ScholarPubMed
49.Suppes, T, Phillips, KA, Judd, C. Clozapine treatment of non-psychotic rapid cycling bipolar disorder: a report of three cases. Biol Psychiatry 1994; 36: 338–40.CrossRefGoogle Scholar
50.Kusumi, I, Ohmori, T, Kohsaka, M, Ito, M, Honma, H, Koyama, T. Chronobiological approach for treatment-resistant rapid cycling affective disorders. Biol Psychiatry 1995; 37: 553–9.CrossRefGoogle ScholarPubMed