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Thomas A. Wehr, MD
Clinical Psychobiology Branch National Institute of Mental Health Room 4S-239, Bldg 10 9000 Rockville Pike Bethesda, MD 20892

Arch Gen Psychiatry. 1993;50(6):495-496.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In the conclusion to their article on rapidly cycling affective disorder, Coryell et al¹ state that "knowledge of those factors that predispose to this condition or that prolong it would have substantial clinical importance."

In this regard, it is worth noting evidence that tricyclic antidepressants (TCAs) or other antidepressants may trigger rapid cycling in a subgroup of bipolar patients.^2,3 However, Coryell et al conclude that "the evidence implicating TCAs in the genesis of rapid cycling is weak." They present three arguments against the evidence.

First, in their own data, Coryell et al found that nearly twice as many patients who became rapid cyclers (33%) as those who did not (18%) were treated with TCAs or monoamine oxidase inhibitors at the time of intake into their study. However, they concluded that "the use of TCAs or monoamine oxidase inhibitors did not seem to anticipate rapid cycling after statistical control . . . [Full Text PDF of this Article]

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