E. Shimizu et al., RECOVERY FROM NEUROENDOCRINOLOGICAL ABNORMALITIES AND FRONTAL HYPOPERFUSION AFTER REMISSION IN A CASE WITH RAPID-CYCLING BIPOLAR DISORDER, PSYCHIATRY AND CLINICAL NEUROSCIENCES, 51(4), 1997, pp. 207-212
A 51-year-old Japanese woman who had been suffering from a rapid cycli
ng affective disorder (RCAD) for 24 years responded to combined clonaz
epam and carbamazepine therapy. Before remission, she showed neuroendo
crinological and neuroimaging abnormalities such as subclinical hypoth
yroidism with exaggerated response to thyrotropin releasing hormone (T
RH) inject-on, non-suppression on the dexamethasone suppression test (
DST) and hypofrontality ill cerebral blood now. Her symptoms improved
remarkably soon after adjunctive clonazepam treatment. After remission
, her biological markers gradually returned to normal. First, subclini
cal hypothyroidism improved 2 months after remission. Next, hypofronta
lity disappeared 18 months later. Furthermore, non-suppression on the
DST normalized 34 months later. The normalization of biological marker
s with apparent recovery from RCAD suggests a decreased risk of relaps
e into mood disorder. These findings reiterate the importance of follo
wing-up on the biological markers in RCAD for years after remission.