The objective of this study was to evaluate the efficacy,safety and tolerability of quetiapine and olanzapine in association with valproate in the treatment of RCBD.

30 patients diagnosed with RCBD by DSM IV criteria were divided in 2 groups - group A included 15 patients treated with quetiapine (600-800mg/day) and group B included 15 patients treated with olanzapinum (10-15 mg/day). Both groups received valproate 500mg/day.

At the beginning of the study 12 patients were maniac, 8 in a mixed state,7 depressed,3 hypomaniac. Patients were assessed with Clinical Global Impression Scale for Bipolars, the Young Mania Rating Scale and the Hamilton Depression Rating Scale.We evaluated al groups at baseline, after 1 week, 2 week, and every month during the period of study (1 year).

A similar and significant improvement was observed in both group for all the scale scores (CGI-BP, YMRS,HDRS). Doses of quetiapine and olanzapinum were significantly reduced by the end of the study in compare with baseline. Doses of quetiapine and olanzapinum differed according to the initial episode.

Quetiapine and olanzapinum in association with valproate were an effective treatment for rapid cycling bipolar patients. Adequate doses for acute episodes could significantly differ according to the episode polarity and the length of treatment.