18. Treatment of Bipolar Disorder in Old Age

  1. Hagop S. Akiskal3 and
  2. Mauricio Tohen4
  1. Kenneth I. Shulman1,
  2. Nathan Herrmann1 and
  3. Martha Sajatovic2

Published Online: 13 APR 2011

DOI: 10.1002/9780470975114.ch18

Bipolar Psychopharmacotherapy: Caring for the Patient, Second Edition

Bipolar Psychopharmacotherapy: Caring for the Patient, Second Edition

How to Cite

Shulman, K. I., Herrmann, N. and Sajatovic, M. (2011) Treatment of Bipolar Disorder in Old Age, in Bipolar Psychopharmacotherapy: Caring for the Patient, Second Edition (eds H. S. Akiskal and M. Tohen), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470975114.ch18

Editor Information

  1. 3

    International Mood Center, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA

  2. 4

    Department of Psychiatry, Division of Mood and Anxiety Disorders, University of Texas Health Science Centre at San Antonio, 7730 Floyd Curl Drive, San Antonio, TX 78229, USA

Author Information

  1. 1

    Department of Psychiatry, Faculty of Medicine, Sunnybrook Health Sciences Center, University of Toronto, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada

  2. 2

    Department of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, OH 44106, USA

Publication History

  1. Published Online: 13 APR 2011
  2. Published Print: 15 APR 2011

ISBN Information

Print ISBN: 9780470747216

Online ISBN: 9780470975114

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Keywords:

  • bipolar;
  • older;
  • adult;
  • geriatric;
  • comorbidity;
  • treatment;
  • guidelines

Summary

Bipolarity in older adults is characterized by a late age of onset and increased cognitive impairment associated with comorbid neurobiologic abnormalities. This group of patients uses significantly more health services and experiences increased mortality rates compared to controls and even unipolar depressed patients. Treatment of older adults includes the full armamentarium available for mixed age patients but requires special consideration because of altered pharmacokinetics (for example, lithium and renal function) and concerns regarding drug-drug interactions. The chapter describes the evidence-based guidelines for treating this vulnerable population including the acute and long-term phases of the disorder.