Rapid cycling affective disorder is characteristically unresponsive to conventional interventions. In bipolar rapid cycling affective disorder, the manic episodes may be controlled with either neuroleptics or electroconvulsive therapy, but the depressive episodes are highly intractable. This report describes the successful treatment of a patient with a bipolar rapid cycling affective disorder using a combination of valproic acid and lithium carbonate.
DunnerDL, FieveRR. Clinical factors in lithium prophylaxis failure. Arch Gen Psychiatry1974; 30: 229–233.
3.
StancerHC, FurlongFW, GhodseCD. A longitudinal investigation of lithium as a prophylactic agent for recurrent depressions. Can Psychiatr Assoc J1970; 15(1): 29–40.
4.
PersadE.Treatment resistant depression and rapid cycling affective disorder. In: McCannD, EndlerN, eds. Depression, new directions in theory, research and practice.Toronto ON: Wall and Emerson Inc., 1990.
5.
SchouM.Lithium prophylaxis: myths and realities. Am J Psychiatry1989; 146: 573–576.
6.
SachsGS. Adjuncts and alternatives to lithium therapy for bipolar illness. J Clin Psychiatry1989; 50(12 Suppl): 31–39.
7.
PostRM. Introduction: emerging perspectives on valproate in affective disorders. J Clin Psychiatry1989; 50(3 Suppl): 3–9.
8.
McElroySL, KeckPE, PopeHG, Valproate in psychiatric disorders: literature review and clinical guideline. J Clin Psychiatry1989; 50(30 Suppl): 23–29.
9.
PopeHG, McElroySL, KeckPEJr, . Valproate in the treatment of acute mania. Arch Gen Psychiatry1991; 48: 62–68.
10.
PostRM, Roy-ByrnePP, UhdeTW. Graphic representation of the life course of illness in patients with affective disorder. Am J Psychiatry1988; 145(7): 844–848.
11.
SchopfJ.Treatment of depressions resistant to tricyclic antidepressants, related drugs or MAO-inhibitors by lithium addition: review of the literature. Pharmacopsychiatry1989; 22: 174–182.
12.
NelsonJC, ByckR.Rapid response to lithium in phenelzine non-responders. Br J Psychiatry1982; 141: 85–86.
13.
KramlingerKG, PostRM. The addition of lithium to Carbamazepin. Arch Gen Psychiatry1989; 46(9): 794–800.
14.
LipowskiZJ. Delirium in the elderly patient. N Engl J Med1989; 320: 578–581.
