title: General principles in the pharmacotherapy of antidepressant-induced rapid cycling: a case series.
abstract: The treatment of depression in patients who rapidly cycle once they receive antidepressant medication is a difficult clinical problem. Hurowitz and Liebowitz presented six patients with antidepressant-induced rapid cycling and proposed guidelines for how to manage medications in these patients. In this article, we present six new cases of antidepressant-induced rapid cycling as well as follow-up from four of the previous cases. We conclude that DSM-IV criteria are not sufficiently sensitive to diagnose antidepressant-induced rapid cycling and that the treatment guidelines of Hurowitz and Liebowitz, although not foolproof, are useful. General recommendations for treating patients with antidepressant-induced rapid cycling are discussed.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
authors.forename: H B
authors.initials: HB
authors.lastname: Simpson
authors.forename: G I
authors.initials: GI
authors.lastname: Hurowitz
authors.forename: M R
authors.initials: MR
authors.lastname: Liebowitz
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000139:chemically induced* / Q000628:therapy*; D003866:Depressive Disorder / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D013974:Thyroxine / Q000627:therapeutic use*
chemical_list: D000928:Antidepressive Agents; D013974:Thyroxine