Valproate in the treatment of rapid-cycling bipolar disorder

Six consecutive patients with rapid-cycling bipolar disorder, refractory or only minimally responsive to treatment with lithium salts and neuroleptics, including five also refractory to carbamazepine, all demonstrated a moderate or marked response to the anticonvulsant valproate. These observations suggest that valproate may represent a promising treatment alternative in this often treatment-resistant form of bipolar disorder.