Rapid cycling in bipolar disorders

: Two patients, a woman aged 32 and a man aged 27 years, were suffering from rapid cycling bipolar disorder (i.e. a course with four or more episodes a year). Hypothyroidism and the use of antidepressants may be involved in the development of such a disease course. Treatment with carbamazepine was successful in both patients. Patients suffering from rapid cycling bipolar disorder should be treated with lithium or carbamazepine, or a combination of these. Antidepressants should only be used with great caution.