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Dr. Bob is Robert Hsiung, MD,
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Posted by sienna on September 27, 2002, at 19:16:26
Could someone explain rapid cycling to me and also how manic do you have to be for it to be called manic? I think i get a little manic at times especially on the Geodon, but my psychologist doesn't think I am manic. Or even hypomanic. Im kind of confused.
Thanks
Sienna
Posted by madison88 on September 28, 2002, at 20:41:56
In reply to What is rapid cycling??, posted by sienna on September 27, 2002, at 19:16:26
I think rapid cycling is going up and down in your mood more than once a week. I know I was going up and down every couple hours for a while. I was on antidepressants without a mood stabilizer. If the med is causing you to cycle, the doc won't consider you manic or hypomanic at times b/c it is being caused by the med. It is common to get moody when coming out of a depression. Mixed states are when you feel agitated and restless but also depressed enough to maybe consider suicide still. If the moods make you feel like you are out of control (that is how i felt), ask for a mood stabilizer. I don't think you need lithium, but Neurontin and Gabitril, which are antiseizure meds actually, have been shown to help with mood swings like that, esp with rapid cyclers (but remember, you won't get diagnosed with anything if it is caused by meds, usually). They both helped me. I had to stop Neurontin, though b/c it blurred my vision, though i don't think that happens to most people. I still go up and down on Gabitril, but i feel much more in control b/c it isn't as near as severe. Good luck!
Posted by sienna on September 30, 2002, at 16:06:18
In reply to Re: What is rapid cycling??, posted by madison88 on September 28, 2002, at 20:41:56
Thanks Madison,
I stillhave no real idea what is wrong with me. Ive tried Lithium and also Depakote, but didnt work. Now im just on the Geodon and it seems to help with depression but its a pretty low dose.
Sienna
Posted by Shawn. T. on October 1, 2002, at 5:05:06
In reply to What is rapid cycling??, posted by sienna on September 27, 2002, at 19:16:26
The most widely accepted standards for hypomania have been published in DSM IV, which includes the guidelines that your psychologist should be following. See http://www.behavenet.com/capsules/disorders/bip2dis.htm for the DSM IV entry for bipolar II disorder, which includes links to diagnostic criteria for mania and hypomania.
Rapid cycling has been defined as four or more affective episodes within one year of illness. I don't believe that this is the definition that most people on this board would be familiar with, however. So called 'ultra-rapid cycling' has been associated with the low activity allele of catechol-O-methyltransferase (COMT) gene. COMT is involved in the breakdown of catecholamines in the brain. Catecholamines include dopamine, noradrenaline (aka norepinephrine), and adrenaline (aka epinephrine). Thus, low activity of the COMT gene involves increased levels of dopamine, noradrenaline, and adrenaline in the brain. My personal feeling is that an alteration of the COMT gene by itself may not contribute significantly to rapid cycling bipolar affective disorder, although the risk increases a great deal when combined with other genetic variations associated with bipolar disorder. I find it interesting that COMT gene alterations and serotonin reuptake inhibitor variations in combination have been associated with bipolar disorder without panic disorder. So the point of all this is that people with rapid cycling bipolar disorder are going to see especially effective treatments available sometime this decade. Having genetic evidence available certainly makes tailoring specific treatment options much less difficult.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=9702744&dopt=Abstracthttp://ajp.psychiatryonline.org/cgi/content/abstract/159/1/23?ijkey=n9trvnLleVd8k
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=8886163&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9702745&dopt=Abstract
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