Recurrence of mania after fourtyfour year remission: a case report

It is widely believed that bipolar disorder is typically a progressive condition, marked by shortening of stable mood periods and of inter-episode cycles over time and increasing number of episodes. However, in many bipolar patients an erratic and unpredictable course of illness may occur. Experienced clinicians are familiar with some patients, whom have not suffered from a relapse of illness for years despite lack of prophylactic treatment. In this report we present a case of mania with 44 years of remission without prophylactic treatment and discuss the preventive therapy in bipolar disorder.