Rapid Cycling BPAD

Question 1

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Which of the following is true regarding rapid cycling bipolar disorder?

It is defined as 6 or more mood episodes in a year

It tends to develop early on in the course of the disorder

Propanolol is effective in the treatment of rapid cycling bipolar disorder

It has an estimated prevalence of 40%

It lasts less than 2 years in approximately 50% of patients

Propanolol is thought to precipitate rapid cycling bipolar disorder and should be discontinued if it occurs.

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Bipolar disorder (Rapid cycling)

Rapid cycling is defined as 4 or more mood episodes per year. It has an estimated prevalence of 10-20% of all patients with bipolar disorder (estimated from specialised western mood disorder clinics). It tends to develop late in the course of the disorder and lasts less than 2 years in 50% of patients. It is associated with an increased risk of suicide.

Compared with non-rapid-cycling bipolar disorder, it is:-

Answer 1

More common in women
Associated with an earlier age at onset
Associated with a greater illness burden
Associated with higher treatment resistance

Question 2

Causes

Answer 2

Hypothyroidism, Graves’ disease, subarachnoid haemorrhage, stroke, multiple sclerosis, head injury, drugs (propranolol, levadopa, cyproheptadine)