WHAT IS CYCLOTHYMIC DISORDER, AND IS PROZAC GOOD FOR IT?

Cyclothymic disorder is a mild form of manic depression that for the most part goes untreated. Indeed, many depression experts consider both hypomanic and cyclothymic patients as highly useful and productive in the society. During the mild highs, these people feel extremely well and are often very productive, while the symptoms of depression in the cyclothymic patient seem to be simply periods of letdown, discouragement, and loss of productivity.

Cyclothymic disorder can be diagnosed after two years (one for children and adolescents) in which a patient who usually continues to function quite reasonably has had several hypomanic episodes along with numerous periods of depression. These ups and downs do not meet the full criteria for major depression. Between the mood swings the symptoms never disappear for longer than two months at a time. Yet there is no clear evidence of a major depressive or manic disorder. The ups are energetic and productive, while the downs are simply tolerable, with the person becoming more pessimistic and withdrawn. Cyclothymics usually remain cyclothymics, and they appear to be afflicted by mild versions of manic-depressive disorder. In some instances, however, the episode may change into full-blown manic depression. Manic depression requires treatment with lithium, and, in some instances, cyclothymia requires lithium treatment as well.

The use of Prozac in cyclothymia has not been adequately studied, but the very nature of the illness makes this an area for caution. Presumably, from all we know about Prozac, it would alleviate the depression. The problem is that it could also accentuate the periods of hypomania. Thus, it could conceivably turn a cyclothymic disorder into full-blown manic depression. For this reason, Prozac should not be used on a long-term basis in cyclothymic patients, and if used in the depressive phase, it should be used very cautiously, and in smaller doses than usual. However, if Prozac is given in conjunction with lithium or one of its alternatives, it could theoretically provide safe, long-term protection against the ups and downs of cyclothymia.

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