Important clinical-legal issues surround the management of patients wi
th rapid-cycling bipolar disorder (RCBD). An increased risk of liabili
ty exposure may exist for improper diagnosis and treatment, lack of in
formed consent, inadequate assessment of the risk of violence toward s
elf and others, and failure to monitor the patient. Practice guideline
s may facilitate defensive practices by psychiatrists, which can incre
ase the risk of liability. Clinical risk management combines professio
nal expertise and knowledge of the patient with an understanding of th
e legal issues governing clinical practice to provide good care to pat
ients and only secondarily to limit legal liability. A working underst
anding of the legal issues surrounding patient care in general and the
RCBD patient in particular should provide more comfort and wider lati
tude in helping these difficult-to-treat patients.