Addition of lamotrigine to valproic acid: A successful outcome in a case of rapid-cycling bipolar affective disorder

摘要

Bipolar patients with rapid-cycling seem to have poorer long-term prognosis (Barrios et al., 2001; Schneck, 2006). We describe a patient with rapid-cycling bipolar disorder who presented a successful outcome after addition of lamotrigine to valproic acid. C. was a 44-year-old single white woman. She was admitted to our department with a three-year history of rapid-cycling mood episodes with several mood switches (four per month). Hypomanic episodes lasted approximately two days and were characterized by insomnia, irritability, increased rate of speech and motor excitement. Depressive states lasted seven days and were marked by feelings of detachment and guilt, Social isolation, fatigue, loss of interest and pleasure.