Background: Lithium, carbamazepine, and valproic acid reduce relapse rates in most bipolar patients. However, some patients with bipolar illness fail to obtain antidepressant benefits from these medications, despite appropriate dosages of and duration on therapy with these drugs.
Method: Three bipolar patients were followed in an open fashion on thymoleptic and neuroleptic medications. With discontinuation of neuroleptics, each patient relapsed into depression and was then restarted on neuroleptic treatment.
Results: These three patients responded rapidly to readministration of neuroleptics to their pharmacologic regimen.
Conclusion: Some bipolar patients experience depressive relapse following neuroleptic discontinuation. With reinstitution of the neuroleptic, they show rapid improvement in mood.