Rapid Cycling: Treatment Guidelines

1
Rapid Cycling Treatment Guidelines

• Is a predictor of positive response to treatment
  with valproate
• Appears to neutralize lithiums antidepressant
  efficacy
• Avoid antidepressants in bipolar II
• First-line therapy
• Start with valproate in bipolar I
• Start with lamotrigine in bipolar II
• Move quickly to combination therapy if first-line
  therapy is not efficacious
• Add lithium, etc

Calabrese JR, et al. J Clin Psychiatry.
200162(suppl 14)34-41.