title: A rapid-cycling bipolar patient treated with long nights, bedrest, and light.
abstract: BACKGROUND
  Stabilization of rapid-cycling bipolar disorder is extremely difficult.
  
  
  METHODS
  A refractory bipolar I rapid-cycling patient on valproate was treated with long "nights" (extended sleep in darkness) and daytime light therapy.
  
  
  RESULTS
  Rapid cycling immediately stopped on initiation of a 10 hour dark/rest period. This was extended to 14 hours (plus a self-selected 1 hour midday nap) without problems. Depression gradually improved when midday light therapy was added; near-euthymia was attained after light therapy was shifted to the morning.
  
  
  CONCLUSIONS
  Nonpharmacological chronobiological treatments may be a means to interrupt rapid cycling.
authors.affiliation: Psychiatric University Clinic, Basel, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Wirz-Justice
authors.forename: C
authors.initials: C
authors.lastname: Quinto
authors.forename: C
authors.initials: C
authors.lastname: Cajochen
authors.forename: E
authors.initials: E
authors.lastname: Werth
authors.forename: C
authors.initials: C
authors.lastname: Hock
mesh_terms: D000204:Activity Cycles / Q000502:physiology*; D000368:Aged; D001510:Bed Rest; D001714:Bipolar Disorder / Q000628:therapy*; D002909:Chronobiology Phenomena; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D010789:Phototherapy; D013997:Time Factors