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David L. Dunner, MD; Ronald R. Fieve, MD

Arch Gen Psychiatry. 1974;30(2):229-233.

Abstract
Failure to prevent the recurrence of manic or depressive episodes was observed in 27 of 55 bipolar (manic-depressive) patients who received lithium carbonate for from 6 to 66 months. Several clinical features of these patients were examined to determine if any predicted lithium carbonate prophylaxis failure.

Patients whose frequency of affective episodes was at least four per year (rapid cyclers) were disproportionally represented in the prophylaxis-failure group. For the nonrapid cyclers, prophylaxis failure occurred mainly in the first year of lithium carbonate treatment and tended to be characterized by more than one affective episode. Most of the rapid cyclers continued to be ill even after two years or more of lithium carbonate treatment, although some beneficial effects of lithium carbonate could be demonstrated in the rapid cycler group.

Author Affiliations
New York

From the New York State Psychiatric Institute, and Columbia University College of Physicians and Surgeons, New York (Dr. Dunner), and the Metabolic Unit and Lithium Clinic, New York State Psychiatric Institute, and Columbia University College of Physicians and Surgeons (Dr. Fieve).

Footnotes
Accepted for publication Oct 10, 1973.

Reprint requests to New York State Psychiatric Institute, 722 W 168th St, New York, NY 10032 (Dr. Dunner).

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References
APPI Online CME 2007;2007:2-2.
FULL TEXT  

Brain-derived neurotrophic factor (BDNF) gene and rapid-cycling bipolar disorder: Family-based association study
MULLER et al.
Br. J. Psychiatry 2006;189:317-323.
ABSTRACT | FULL TEXT  

Genetic variation of brain-derived neurotrophic factor (BDNF) in bipolar disorder: Case-control study of over 3000 individuals from the UK
GREEN et al.
Br. J. Psychiatry 2006;188:21-25.
ABSTRACT | FULL TEXT  

A 20-Month, Double-Blind, Maintenance Trial of Lithium Versus Divalproex in Rapid-Cycling Bipolar Disorder
Calabrese et al.
Am. J. Psychiatry 2005;162:2152-2161.
ABSTRACT | FULL TEXT  

Familial Variation in Episode Frequency in Bipolar Affective Disorder
Fisfalen et al.
Am. J. Psychiatry 2005;162:1266-1272.
ABSTRACT | FULL TEXT  

Comparison of Rapid-Cycling and Non-Rapid-Cycling Bipolar Disorder Based on Prospective Mood Ratings in 539 Outpatients
Kupka et al.
Am. J. Psychiatry 2005;162:1273-1280.
ABSTRACT | FULL TEXT  

Rapid cycling is equivalently prevalent in bipolar I and bipolar II disorder, and is associated with female gender and greater severity of illness
Mackin
Evid. Based Ment. Health 2005;8:52-52.
FULL TEXT  

Phenomenology of Rapid-Cycling Bipolar Disorder: Data From the First 500 Participants in the Systematic Treatment Enhancement Program
Schneck et al.
Am. J. Psychiatry 2004;161:1902-1908.
ABSTRACT | FULL TEXT  

The Long-term Course of Rapid-Cycling Bipolar Disorder
Coryell et al.
Arch Gen Psychiatry 2003;60:914-920.
ABSTRACT | FULL TEXT  

Defining Clinical Phenotypes of Juvenile Mania
Leibenluft et al.
Am. J. Psychiatry 2003;160:430-437.
ABSTRACT | FULL TEXT  

Bibliography for Bipolar Disorder
Focus 2003;1:32-33.
FULL TEXT  

Practice Guideline for the Treatment of Patients With Bipolar Disorder (Revision)
Hirschfeld et al.
Focus 2003;1:64-110.
FULL TEXT  

Mania and Attention Deficit Hyperactivity Disorder in a Prepubertal Child: Diagnostic and Treatment Challenges
State et al.
Am. J. Psychiatry 2002;159:918-925.
FULL TEXT  

Use of antipsychotic drugs and lithium in mania
COOKSON
Br. J. Psychiatry 2001;178 :s148-s156.
ABSTRACT | FULL TEXT  

Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders
TONDO et al.
Br. J. Psychiatry 2001;178 :s184-s190.
ABSTRACT | FULL TEXT  

Sex Differences in Response to Lithium Treatment
Viguera et al.
Am. J. Psychiatry 2000;157:1509-1511.
ABSTRACT | FULL TEXT  

Reliability and Validity of Four Alternative Definitions of Rapid-Cycling Bipolar Disorder
Maj et al.
Am. J. Psychiatry 1999;156:1421-1424.
ABSTRACT | FULL TEXT  

Omega 3 Fatty Acids in Bipolar Disorder: A Preliminary Double-blind, Placebo-Controlled Trial
Stoll et al.
Arch Gen Psychiatry 1999;56:407-412.
ABSTRACT | FULL TEXT  

Long-Term Outcome of Lithium Prophylaxis in Bipolar Disorder: A 5-Year Prospective Study of 402 Patients at a Lithium Clinic
Maj et al.
Am. J. Psychiatry 1998;155:30-35.
ABSTRACT | FULL TEXT  

Understanding Manic-depressive Illness
Goodwin and Ghaemi
Arch Gen Psychiatry 1998;55:23-25.
FULL TEXT  

Pharmacologic Treatment of Bipolar Disorder Through the Life Cycle
Jackson
Journal of Pharmacy Practice 1996;9:95-103.
ABSTRACT  

Progress in Psychiatry- Second of Two Parts
Michels and Marzuk
NEJM 1993;329:628-638.
FULL TEXT  

Rapidly Cycling Affective Disorder: Demographics, Diagnosis, Family History, and Course
Coryell et al.
Arch Gen Psychiatry 1992;49:126-131.
ABSTRACT  

The management of treatment-resistant affective disorder: clinical perspectives
Malizia and Bridges
J Psychopharmacol 1992;6:145-155.
 

Outcome in Manic Disorders: A Naturalistic Follow-up Study
Harrow et al.
Arch Gen Psychiatry 1990;47:665-671.
ABSTRACT  

Rapid Cycling Bipolar Affective Disorder: I. Association With Grade I Hypothyroidism
Bauer et al.
Arch Gen Psychiatry 1990;47:427-432.
ABSTRACT  

Rapid Cycling Bipolar Affective Disorder: II. Treatment of Refractory Rapid Cycling With High-Dose Levothyroxine: A Preliminary Study
Bauer and Whybrow
Arch Gen Psychiatry 1990;47:435-440.
ABSTRACT  

Response to Maintenance Therapy in Bipolar Illness: Effect of Index Episode
Shapiro et al.
Arch Gen Psychiatry 1989;46:401-405.
ABSTRACT  

Rapid Cycling Mood Disorder in the Elderly
Conlon
J Geriatr Psychiatry Neurol 1989;2:106-108.
ABSTRACT  

Penrsistent Tardive Dyskinesia in Bipolar Patients
Mukherjee et al.
Arch Gen Psychiatry 1986;43:342-346.
ABSTRACT  

RBC Membrane Adenosine Triphosphatase Activities in Patients With Major Affective Disorders
Linnoila et al.
Arch Gen Psychiatry 1983;40:1021-1026.
ABSTRACT  

Clorgyline: A New Treatment for Patients With Refractory Rapid-Cycling Disorder
Potter et al.
Arch Gen Psychiatry 1982;39:505-510.
ABSTRACT  

Treatment of Intractable Rapid-Cycling Manic-Depressive Disorder With Levothyroxine: Clinical Observations
Stancer and Persad
Arch Gen Psychiatry 1982;39:311-312.
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Prediction of Treatment Response in Mania
Taylor and Abrams
Arch Gen Psychiatry 1981;38:800-803.
ABSTRACT  

Prediction of Treatment Outcome With Lithium
Carroll
Arch Gen Psychiatry 1979;36:870-878.
ABSTRACT  

Incidence and Significance of Mixed Affective States in a Bipolar Population
Himmelhoch et al.
Arch Gen Psychiatry 1976;33:1062-1066.
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Prophylaxis of Affective Disorders: Current Status of Knowledge
Quitkin et al.
Arch Gen Psychiatry 1976;33:337-341.
ABSTRACT  

The Life Table: A Method for Analyzing Longitudinal Studies
Fleiss et al.
Arch Gen Psychiatry 1976;33:107-112.
ABSTRACT  

Lithium Carbonate and Affective Disorders: V: A Double-Blind Study of Prophylaxis of Depression in Bipolar Illness
Dunner et al.
Arch Gen Psychiatry 1976;33:117-120.
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Acute Mania: Clinical and Genetic Study of Responders and Nonresponders to Treatments
Taylor and Abrams
Arch Gen Psychiatry 1975;32:863-865.
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