Peijun Chen1, Annemiek Dols2, Soham Rej3,4, Martha Sajatovic5. 1. Department of Psychiatry, Case Western Reserve University School of Medicine, Louis Stokes Veterans Administration Medical Center, Cleveland, OH, USA. 2. Department of Old Age Psychiatry, GGZ inGeest, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada. 4. Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada. 5. Departments of Psychiatry and of Neurology, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, 10524 Euclid Avenue, Cleveland, OH, 44106, USA. Martha.sajatovic@uhhospitals.org.
Abstract
PURPOSE OF REVIEW: The population over age 60 is growing more rapidly than the general population. Given the projected increase and need for data that can inform treatment, this review provides a brief description of newer publications focused on mania in older-age bipolar disorder (OABD), including epidemiology, diagnosis, and treatments. RECENT FINDINGS: Age cutoffs to define OABD range from 50 to 65 years. OABD clinical presentation and course of illness is highly variable, often characterized by mood episode recurrence, medical comorbidity, cognitive deficits, and impaired functioning. There is little pharmacotherapy data on mania in OABD. Lithium and valproate have been tested in a single randomized controlled trial and there is data of more limited quality with other compounds. Treating OABD is challenging due to medical complexity, comorbidity, diminished tolerance to treatment, and a limited evidence base. More data is needed to keep pace with clinical demand.
PURPOSE OF REVIEW: The population over age 60 is growing more rapidly than the general population. Given the projected increase and need for data that can inform treatment, this review provides a brief description of newer publications focused on mania in older-age bipolar disorder (OABD), including epidemiology, diagnosis, and treatments. RECENT FINDINGS: Age cutoffs to define OABD range from 50 to 65 years. OABD clinical presentation and course of illness is highly variable, often characterized by mood episode recurrence, medical comorbidity, cognitive deficits, and impaired functioning. There is little pharmacotherapy data on mania in OABD. Lithium and valproate have been tested in a single randomized controlled trial and there is data of more limited quality with other compounds. Treating OABD is challenging due to medical complexity, comorbidity, diminished tolerance to treatment, and a limited evidence base. More data is needed to keep pace with clinical demand.
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