Intractable manic-depressive psychosis with rapid cycling in an 18-year-old woman successfully treated with electroconvulsive therapy.

An adolescent patient with a history of progressively more severe seasonal depression subsequently developed a refractory manic-depressive psychosis with rapid cycling after the initiation of treatment with trimipramine. A complete remission was obtained after a course of six electroconvulsive therapy (ECT) treatments. This unusual case and its outcome are discussed in terms of apparent drug-induced rapid cycling and the treatment of this condition. It is suggested that ECT can be successfully used as an alternative therapeutic option for patients with intractable rapid-cycling manic-depressive disorder.