48-HOUR RAPID-CYCLING - RESULTS OF PSYCHOPATHOMETRIC, POLYSOMNOGRAPHIC, PET IMAGING AND NEUROENDOCRINE LONGITUDINAL INVESTIGATIONS IN A SINGLE-CASE

We report a 64-year-old patient suffering from rapid cycling bipolar d isorder who was studied by means of polysomnography, neuroendocrine te sts and PET (positron emission tomography) imaging. In a manner only p artly compatible with the cholinergic-aminergic imbalance model of man ia and depression, a linkage of REM sleep disinhibition and depressive mood was observed, but no decisive REM sleep delay was seen on manic days. Growth hormone secretion after clonidine stimulation was blunted on depressive and hypomanic days. A series of total sleep deprivation s led to a positive effect on psychopathology for about two weeks. Car bamazepine treatment normalized REM sleep variables, damped the amplit ude of mood cycling of the patient, increased TSH and decreased FT4.