Emerging trends in the treatment of rapid cycling bipolar disorder: A selected review

Robert M. Post, Mark A. Frye, Kirk D. Denicoff, Gabriele S. Leverich, Robert T. Dunn, Elizabeth A. Osuch, Andrew M. Speer, Gabriela Obrocea, Kamal Jajodia

Research output: Contribution to journalReview articlepeer-review

36 Scopus citations


Recent evidence suggests that lithium therapy (even as supplemented by antidepressants and neuroleptics) is inadequate for the majority of patients with bipolar illness, and particularly those with rapid cycling. Valproate and carbamazepine have emerged as adjuncts and alternatives, but they, too, often require additional approaches with lithium, thyroid hormones, and other putative mood stabilizers, including nimodipine (and related dihydropyridine calcium channel blockers), lamotrigine, gabapentin, topiramate, and the atypical neuroleptics. Evaluating how these agents and the unimodal antidepressants are optimally applied and sequenced in the treatment of bipolar illness with its multiple subtypes, patterns and comorbidities will require much future investigation and the development of new methodological clinical trial approaches.

Original languageEnglish (US)
Pages (from-to)305-315
Number of pages11
JournalBipolar disorders
Issue number4
StatePublished - Dec 2000


  • Anticonvulsants
  • Calcium channel blockers
  • Carbamazepine
  • Gabapentin
  • Lamotrigine
  • Lithium
  • Nimodipine
  • Repeated transcranial magnetic stimulation (rTMS)
  • Tolerance
  • Valproate

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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