Rapid Cycling Bipolar Disorder
How Is Rapid Cycling Bipolar Disorder Treated? continued...
Antidepressants such as Prozac, Paxil, and Zoloft have not been shown to treat the depression symptoms of rapid cycling bipolar disorder, and may even increase the frequency of depressive recurrences over time. Many experts therefore advise against the use of antidepressants (especially long term) in bipolar patients with rapid cycling.
Mood-stabilizing drugs -- such as lithium Depakote, Tegretol or Lamictal -- are the core treatments of rapid cycling. Often, a single mood stabilizer is ineffective at controlling episode recurrences, resulting in a need for combinations of mood stabilizers. Several antipsychotic medicines such as Zyprexa or Seroquel also have been studies in rapid cycling and are used as part of a treatment regimen, regardless of the presence or absence of psychosis (delusions and hallucinations).
Treatment with mood stabilizers is usually continued even when a person is symptom-free. This helps prevent rapid cycling. Antidepressants, if and when used, are generally tapered as soon as depression is under control.
What Are the Risks of Rapid Cycling Bipolar Disorder?
The most serious risk of rapid cycling bipolar disorder is suicide. People with bipolar disorder are 10 times to 20 times more likely to commit suicide than people without bipolar disorder. Tragically, 8% to 20% of people with bipolar disorder eventually lose their lives to suicide.
People with rapid cycling bipolar disorder are probably at even higher risk for suicide than those with nonrapid cycling bipolar disorder. They are hospitalized more often, and their symptoms are usually more difficult to control long term.
Treatment reduces the likelihood of serious depression and suicide. Lithium in particular, taken long term, reduces the risk.
People with bipolar disorder are also at higher risk for substance abuse. Nearly 60% of people with bipolar disorder abuse drugs or alcohol. Substance abuse is associated with more severe or poorly controlled bipolar disorder.