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Rapid-Cycling Bipolar Disorder: Emerging Treatments and Enduring Controversies

Authors: Joseph F. Goldberg, MD; Jinger Hoop, MDFaculty and Disclosures

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Introduction

Rapid cycling is a descriptive term referring to the presence of 4 or more discrete affective episodes in a 1-year period. For patients, it may bring frequent hospitalizations and severe life disruptions. For their physicians, rapid cycling often means frustrating attempts to manage a phase of bipolar illness that can render traditional pharmacotherapies ineffective. However, in recent years, investigators have begun to better understand the clinical importance of this condition, and key questions about its nature and management have come into focus. The result is that clinicians can now have a clearer understanding of the phenomenology of rapid cycling and greater confidence in their ability to treat it.