title: Role of atypical antipsychotics in rapid cycling bipolar disorder: a review of the literature.
abstract: BACKGROUND
  The role of atypical antipsychotics in the management of bipolar disorder continues to expand. This review summarizes the literature on use of atypicals in rapid cycling bipolar disorder in clinical practice and highlights areas for future study.
  
  
  METHODS
  A PubMed search was done using keywords rapid cycling, atypical antipsychotics, refractory bipolar, aripiprazole, clozapine, olanzapine, risperidone, quetiapine, and ziprasidone. Reference lists from original peer-reviewed articles, review articles, and book chapters were reviewed and articles were extracted.
  
  
  RESULTS
  Data on the use of atypical antipsychotics in rapid cycling bipolar disorder are sparse. Atypical antipsychotics may be effective as anti-manic agents during acute mania and may reduce depressive symptoms when used for short and intermediate durations. Their efficacy as mood stabilizers in maintenance therapy has not been demonstrated.
  
  
  CONCLUSIONS
  The study of atypical antipsychotics in rapid cycling bipolar disorder is in its infancy. Although atypical antipsychotics are useful in acute mania, current data do not support their use as maintenance agents. Future double-blind, randomized studies are needed to establish their efficacy relative to traditional mood stabilizers and their utility as adjuvant agents in this subset of patients.
authors.affiliation: Department of Internal Medicine, Division of Medicine/Psychiatry, Southern Illinois University School of Medicine, Springfield, IL, USA. mzupancic@siumed.edu
authors.forename: Melanie L
authors.initials: ML
authors.lastname: Zupancic
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents