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Treatment of Bipolar Disorder in Special Populations

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Book cover Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis, and Pharmacotherapy

Part of the book series: Milestones in Drug Therapy ((MDT))

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Abstract

Though often considered a young person’s disease because its mean age of onset is in late adolescence, bipolar disorder (BD) frequently demonstrates recurrent episodes and morbidities that continue throughout the lifetime of the patient and into old age. In fact, presentation of mood episodes in older age is quite common and requires clinicians to understand the unique challenges that the interaction of aging and mental illness present. Further, it has been well established that the depressive polarity of episodes increases in frequency over the life span with a decline in manic and mixed episode presentations. Finally, while new onset of illness is relatively rare in later ages, it is not unknown, and the variability of age of onset may allow for a better understanding of the disease process. This chapter reviews our current understanding of BD in the elderly and highlights the implications of age in understanding the heuristic causes of the disease, challenges to treatment, and the limitations of our knowledge for clinical care.

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References

  • Al Jurdi RK, Marangell LB, Petersen NJ et al (2008) Prescription patterns of psychotropic medications in elderly compared with younger participants who achieved a “recovered” status in the Systematic Treatment Enhancement Program for Bipolar Disorder. Am J Geriatr Psychiatry 16:922–933

    Article  PubMed  PubMed Central  Google Scholar 

  • Aldenkamp AP, De Krom M, Reijs R (2003) Newer antiepileptic drugs and cognitive issues. Epilepsia 44(Suppl 4):21–29

    Article  CAS  PubMed  Google Scholar 

  • Alexopoulos GS, Streim J, Carpenter D, Docherty JP, Expert Consensus Panel for Using Antipsychotic Drugs in Older Patients (2004) Using antipsychotic agents in older patients. J Clin Psychiatry 65(Suppl 2):5–99

    PubMed  Google Scholar 

  • Almeida OP, Fenner S (2002) Bipolar disorder: similarities and differences between patients with illness onset before and after 65 years of age. Int Psychogeriatr 14(3):311–322

    Article  PubMed  Google Scholar 

  • Altshuler LL, Curran JG, Hauser P, Mintz J, Denicoff K, Post R (1995) T2 hyperintensities in bipolar disorder: magnetic resonance imaging comparison and literature meta-analysis. Am J Psychiatry 152(8):1139–1144

    Article  CAS  PubMed  Google Scholar 

  • American Diabetes Association; American Psychiatric Association; American Association of Clinical Endocrinologists; North American Association for the Study of Obesity (2004) Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry 65(2):267–272

    Article  Google Scholar 

  • American Psychiatric Association (2002) Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry 159(4 Suppl):1–50

    Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Arlington, VA

    Book  Google Scholar 

  • Angst J (1978) The course of affective disorders. II. Typology of bipolar manic-depressive illness. Arch Psychaitr Nervenkr 226:65–73

    Article  CAS  Google Scholar 

  • Angst J, Preisig M (1995) Course of a clinical cohort of unipolar, bipolar and schizoaffective patients. Results of a prospective study from 1959 to 1985. Schweiz Arch Neurol Psychiatr 146(1):5–16

    CAS  PubMed  Google Scholar 

  • Angst J, Baastrup P, Grof P, Hippius H, Poldinger W, Weis P (1973) The course of monopolar depression and bipolar psychoses. Psychiat Neurol Neurochir 76:489–500

    CAS  PubMed  Google Scholar 

  • Baron M, Mendlewicz J, Klotz J (1981) Age-of-onset and genetic transmission in affective disorders. Acta Psychiatr Scand 64(5):373–380

    Article  CAS  PubMed  Google Scholar 

  • Baruch Y, Tadger S, Plopski I, Barak Y (2013) Asenapine for elderly bipolar manic patients. J Affect Disord 145(1):130–132

    Article  CAS  PubMed  Google Scholar 

  • Battino D, Croci D, Rossini A, Messina S, Mamoli D, Perucca E (2003) Serum carbamazepine concentrations in elderly patients: a case-matched pharmacokinetic evaluation based on therapeutic drug monitoring data. Epilepsia 44(7):923–929

    Article  CAS  PubMed  Google Scholar 

  • Bellivier F, Golmard J-L, Henry C, Leboyer M, Schurhoff F (2001) Admixture analysis of age at onset in bipolar I affective disorder. Arch Gen Psychiatry 58:510–512

    Article  CAS  PubMed  Google Scholar 

  • Bellivier F, Golmard J-L, Rietschel M, Schulze TG, Malafosse A, Priesig M, McKeon P, Mynett-Johnson L, Henry C, Leboyer M (2003) Age at onset in bipolar I affective disorder: further evidence for three subgroups. Am J Psychiatry 160:999–1001

    Article  PubMed  Google Scholar 

  • Beyer JL, Siegal A, Kennedy JS, Kaiser C, Tohen K, Berg P, Street J, Baker R, Tohen, M, Tollefson G, Breier A (2001) Olanzapine, divalproex, and placebo treatment non-head-to-head comparisons of older adult acute mania. Presented at the International Psychogeriatric Association, Nice, France

    Google Scholar 

  • Beyer JL, Kuchibhatla M, Cassidy F, Looney C, Krishnan KRR (2003) Social support in elderly patients with bipolar disorder. Bipol Disord 5:22–27

    Article  Google Scholar 

  • Beyer JL, Kuchibhatla M, Payne ME et al (2004) Hippocampal volume measurement in older adults with bipolar disorder. Am J Geriatr Psychiatry 12:613–620

    Article  PubMed  Google Scholar 

  • Beyer JL, Kuchibhatla M, Gersing K, Krishnan KRR (2005) Medical comorbidity in an outpatient bipolar clinical population. Neuropsychopharmacology 30(2):401–404

    Article  PubMed  Google Scholar 

  • Beyer JL, Burchitt B, Gersing K, Krishnan KRR (2008) Patterns of pharmacotherapy and treatment response in elderly adults with bipolar disorder. Psychopharm Bull 41:102–114

    Google Scholar 

  • Beyer JL, Young R, Kuchibhatla M, Krishnan KR (2009) Hyperintense MRI lesions in bipolar disorder: a meta-analysis and review. Int Rev Psychiatry 21:394–409

    Article  PubMed  PubMed Central  Google Scholar 

  • Biffin F, Tahtalian S, Filia K, Fitzgerald PB, de Castella AR, Filia S, Berk M, Dodd S, Callaly P, Berk L, Kelin K, Smith M, Montgomery W, Kulkarni J (2009) The impact of age at onset of bipolar I disorder on functioning and clinical presentation. Acta Neuropsychiatr 21(4):191–196

    Article  PubMed  Google Scholar 

  • Bowden CL, Singh V (2005) Valproate in bipolar disorder: 2000 onwards. Acta Psychiatr Scand Suppl 426:13–20

    Article  CAS  Google Scholar 

  • Bowden CL, Lawson DM, Cunningham M et al (2002) The role of divalproex in the treatment of bipolar disorder. Psychiatr Ann 32(12):742–750

    Article  Google Scholar 

  • Broadhead J, Jacoby R (1990) Mania in old age: a first prospective study. Int J Geriatr Psychiatry 5:215–222

    Article  Google Scholar 

  • Calabrese JR, Shelton MD, Rapport DJ, Kimmel SE (2002) Bipolar disorders and the effectiveness of novel anticonvulsants. J Clin Psychiatry 63(Suppl 3):5–9

    CAS  PubMed  Google Scholar 

  • Carlson GA, Davenport YB, Jamison K (1977) A comparison of outcome in adolescent- and later-onset bipolar manic-depressive illness. Am J Psychiatry 134(8):919–922

    Article  CAS  PubMed  Google Scholar 

  • Carlson GA, Bromet EJ, Sievers S (2000) Phenomenology and outcome of subjects with early- and adult-onset psychotic mania. Am J Psychiatry 157(2):213–219

    Article  CAS  PubMed  Google Scholar 

  • Cassidy F, Carroll BJ (2002) Vascular risk factors in late onset mania. Psychol Med 32(2):359–362

    Article  PubMed  Google Scholar 

  • Catterson ML, Preskorn SH, Martin RL (1997) Pharmacodynamic and pharmacokinetic considerations in geriatric psychopharmacology. Psychiatr Clin North Am 20(1):205–218

    Article  CAS  PubMed  Google Scholar 

  • Charney DS, Reynolds CF III, Lewis L, Lebowitz BD, Sunderland T, Alexopoulos GS, Blazer DG, Katz IR, Meyers BS, Arean PA, Borson S, Brown C, Bruce ML, Callahan CM, Charlson ME, Conwell Y, Cuthbert BN, Devanand DP, Gibson MJ, Gottlieb GL, Krishnan KR, Laden SK, Lyketsos CG, Mulsant BH, Niederehe G, Olin JT, Oslin DW, Pearson J, Persky T, Pollock BG, Raetzman S, Reynolds M, Salzman C, Schulz R, Schwenk TL, Scolnick E, Unutzer J, Weissman MM, Young RC, Depression and Bipolar Support Alliance (2003) Depression and Bipolar Support Alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life. Arch Gen Psychiatry 60(7):664–72

    Google Scholar 

  • Chen ST, Altshuler LL, Melnyk KA et al (1999) Efficacy of lithium vs. valproate in the treatment of mania in the elderly: a retrospective study. J Clin Psychiatry 60:181–185

    Article  CAS  PubMed  Google Scholar 

  • Chu D, Gildengers AG, Houck PR, Anderson SJ, Mulsant BH, Reynolds CF, Kupfer DJ (2010) Does age at onset have clinical significance in older adults with bipolar disorder? Int J Geriatr Psychiatry 25(12):1266–1271

    Article  PubMed  PubMed Central  Google Scholar 

  • DeBattista C, Schatzberg AF (2006) Current psychotropic dosing and monitoring guidelines. Prim Psychiatry 13(6):61–81

    Google Scholar 

  • Depp CA, Jeste DV (2004) Bipolar disorder in older adults: a critical review. Bipol Disord 6:343–367

    Article  Google Scholar 

  • Depp CA, Jin H, Mohamed S, Kaskow J, Moore DJ, Jeste DV (2004) Bipolar disorder I middle-aged and elderly adults: is age of onset important? J Nerv Ment Dis 192(11):796–799

    Article  PubMed  Google Scholar 

  • Dhingra U, Rabins PV (1991) Mania in the elderly: a 5-7 year follow-up. J Am Geriatr Soc 39(6):581–583

    Article  CAS  PubMed  Google Scholar 

  • Eagles JM, Whalley LJ (1985) Ageing and affective disorders: the age at first onset of affective disorders in Scotland, 1969-1978. Br J Psychiatry 147:180–187

    Article  CAS  PubMed  Google Scholar 

  • Ettner S, Hermann R (1998) Inpatient psychiatric treatment of elderly Medicare beneficiaries. Psychiatr Serv 49:1173–1179

    Article  CAS  PubMed  Google Scholar 

  • Evans DL, Byerly MJ, Greer RA (1995) Secondary mania: diagnosis and treatment. J Clin Psychiatry 56(Suppl 3):31–37

    PubMed  Google Scholar 

  • Fenn HH, Sommer BR, Ketter TA, Alldredge B (2006) Safety and tolerability of mood-stabilising anticonvulsants in the elderly. Expert Opin Drug Saf 5(3):401–416

    Article  CAS  PubMed  Google Scholar 

  • Food and Drug Administration. Carbamazepine prescribing information to include recommendation of genetic test for patients with Asian ancestry. FDA News. December 12, 2007. Accessed February 17, 2008 at http://www.fda.gov/bbs/topics/NEWS/2007/NEW01755.html

  • Food and Drug Administration. FDA issues public health advisory for antipsychotic drugs used for treatment of behavioral disorders in elderly patients. FDA News. April 11 2005. Accessed March 3, 2008 at http://www.fda.gov/bbs/topics/ANSWERS/2005/ANS01350.html

  • Forester BP, Streeter CC, Berlow YA et al (2009) Brain lithium levels and effects on cognition and mood in geriatric bipolar disorder: a lithium-7 magnetic resonance study. Am J Geriatr Psychiatry 17:13–23

    Article  PubMed  PubMed Central  Google Scholar 

  • Foster JR (1992) Use of lithium in elderly psychiatric patients: a review of the literature. Lithium 3:77–93

    Google Scholar 

  • Frye MA, Altshuler LL, Bitran JA (1996) Clozapine in rapid cycling bipolar disorder. J Clin Psychopharmacol 16(1):87–90

    Article  CAS  PubMed  Google Scholar 

  • Ghadirian AM, Lalinec-Michaud M, Engelsmann F (1986) Early and late onset affective disorders: clinical and family characteristics. Ann R I C P 19:53–57

    Google Scholar 

  • Gildengers AG, Chisholm D, Butters MA et al (2012) Two-year course of cognitive function and instrumental activities of daily living in older adults with bipolar disorder: evidence for neuroprogression? Psychol Med 43(4):1–11

    Google Scholar 

  • Glasser M, Rabins P (1984) Mania in the elderly. Age Ageing 13:210–213

    Article  CAS  PubMed  Google Scholar 

  • Goodwin GM, Consensus Group of the British Association for Psychopharmacology (2009) Evidence-based guidelines for treating bipolar disorder: revised second edition--recommendations from the British Association for Psychopharmacology. J Psychopharmacol 23(4):346–388

    Article  CAS  PubMed  Google Scholar 

  • Goodwin FK, Jamison KR (1984) The natural course of manic depressive illness. In: Post RM, Ballenger JC (eds) Neurobiology of mood disorders. Williams & Wilkens, Baltimore, pp 20–37

    Google Scholar 

  • Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller HJ, Kasper S (2009) The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2009 on the treatment of acute mania. World J Biol Psychiatry 10(2):85–116

    Article  PubMed  Google Scholar 

  • Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Möller HJ, Kasper S; WFSBP Task Force On Treatment Guidelines For Bipolar Disorders (2010) The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression. World J Biol Psychiatry 11(2):81–109

    Google Scholar 

  • Hamshere ML, Gordon-Smith K, Forty L, Jones L, Caesar S, Fraser C, Hyde S, Tredget J, Kirov G, Jones I, Craddock N, Smith DJ (2009) Age-at-onset in bipolar-I disorder: mixture analysis of 1369 cases identifies three distinct clinical sub-groups. J Affect Disord 116(1–2):23–29

    Article  PubMed  Google Scholar 

  • Hays JC, Krishnan KR, George LK, Blazer DG (1998) Age of first onset of bipolar disorder: demographic, family history, and psychosocial correlates. Depress Anxiety 7(2):76–82

    Article  CAS  PubMed  Google Scholar 

  • Himmelhoch J, Neil J, May S et al (1980) Age, dementia, dyskinesias, and lithium response. Am J Psychiatry 137:941–945

    Article  CAS  PubMed  Google Scholar 

  • Hirschfeld RM, Vornik LA (2004) Recognition and diagnosis of bipolar disorder. J Clin Psychiatry 65(Suppl 15):5–9

    PubMed  Google Scholar 

  • Hirschfeld RM, Lewis L, Vornik LA (2003) Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry 64(2):161–174

    Article  PubMed  Google Scholar 

  • Hopkinson G (1964) A genetic study of affective illness in patients over 50. Br J Psychiatry 110:244–254

    Article  CAS  PubMed  Google Scholar 

  • Hussein Z, Posner J (1997) Population pharmacokinetics of lamotrigine monotherapy in patients with epilepsy: retrospective analysis of routine monitoring data. Br J Clin Pharmacol 43(5):457–465

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • James NM (1977) Early and late onset bipolar affective disorder: a genetic study. Arch Gen Psychiatry 34:715–717

    Article  CAS  PubMed  Google Scholar 

  • Jeste DV, Rockwell E, Harris MJ, Lohr JB, Lacro J (1999) Conventional vs. newer antipsychotics in elderly patients. Am J Geriatr Psychiatry 7(1):70–76

    Article  CAS  PubMed  Google Scholar 

  • Kando JC, Tohen M, Castillo J et al (1996) The use of valproate in an elderly population with affective symptoms. J Clin Psychiatry 57:238–240

    CAS  PubMed  Google Scholar 

  • Kemp DE, Gao K, Chan PK, Canocy SJ, Findling RL, Clabrese JR (2010) Medical comorbidity in bipolar disorder: relationship between illnesses of the endocrine/metabolic system and treatment outcome. Bipolar Disord 12(4):404–413

    Article  PubMed  PubMed Central  Google Scholar 

  • Kessing LV (2006) Diagnostic subtypes of bipolar disorder in older versus younger adults. Bipolar Disord 8(1):56–64

    Article  PubMed  Google Scholar 

  • Klap R, Unroe KT, Unutzer J (2003) Caring for mental illness in the United States: a focus on older adults. Am J Geriatr Psychiatry 11(5):517–524

    Article  PubMed  Google Scholar 

  • Kohen I, Lester PE, Lam S (2010) Antipsychotic treatments for the elderly: efficacy and safety of aripiprazole. Neuropsychiatr Dis Treat 6:47–58

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kujala I, Rosenvinge B, Bekkelund SI (2002) Clinical outcome and adverse effects of electroconvulsive therapy in elderly psychiatric patients. J Geriatr Psychiatry Neurol 15(2):73–76

    Article  PubMed  Google Scholar 

  • Lala SV, Sajatovic M (2012) Medical and psychiatric comorbidities among elderly individuals with bipolar disorder: a literature review. J Geriatr Psychiatry Neurol 25(1):20–25

    Article  PubMed  Google Scholar 

  • Laursen TM, Munk-Olsen T, Nordentoft M, Mortensen PB (2007) Increased mortality among patients admitted with major psychiatric disorders: a register-based study comparing mortality in unipolar depressive disorder, bipolar affective disorder, schizoaffective disorder, and schizophrenia. J Clin Psychiatry 68(6):899–907

    Article  PubMed  Google Scholar 

  • Leboyer M, Henry C, Paillere-Martinot ML, Bellivier F (2005) Age of onset in bipolar affective disorders: a review. Bipolar Disord 7(2):111–118

    Article  PubMed  Google Scholar 

  • Lim PZ, Tunis SL, Edell WS, Jensik SE, Tohen M (2001) Medication prescribing patterns for patients with bipolar I disorder in hospital settings: adherence to published practice guidelines. Bipolar Disord 3(4):165–173

    Article  CAS  PubMed  Google Scholar 

  • Little JD, Atkins MR, Munday J, Lyall G, Greene D, Chubb G, Orr M (2004) Bifrontal electroconvulsive therapy in the elderly: a 2-year retrospective. J ECT 20(3):139–141

    Article  PubMed  Google Scholar 

  • Loranger A, Levine PM (1978) Age at onset of bipolar affective illness. Arch Gen Psychiatry 35:1345–1348

    Article  CAS  PubMed  Google Scholar 

  • Madhusoodanan S, Brenner R, Araujo L, Abaza A (1995) Efficacy of risperidone treatment for psychoses associated with schizophrenia, schizoaffective disorder, bipolar disorder, or senile dementia in 11 geriatric patients: a case series. J Clin Psychiatry 56(11):514–518

    CAS  PubMed  Google Scholar 

  • Madhusoodanan S, Brecher M, Brenner R, Kasckow J, Kunik M, Negron AE, Pomara N (1999) Risperidone in the treatment of elderly patients with psychotic disorders. Am J Geriatr Psychiatry 7(2):132–138

    Article  CAS  PubMed  Google Scholar 

  • Madhusoodanan S, Brenner R, Alcantra A (2000) Clinical experience with quetiapine in elderly patients with psychotic disorders. J Geriatr Psychiatry Neurol 13(1):28–32

    Article  CAS  PubMed  Google Scholar 

  • Manchia M, Lampus S, Chillotti C, Sardu C, Ardau R, Severino G, Del Zompo M (2008) Age at onset in Sardinian bipolar I patients: evidence for three subgroups. Bipolar Disord 10(3):443–446

    Article  PubMed  Google Scholar 

  • McDonald WM (2000) Epidemiology, etiology, and treatment of geriatric mania. J Clin Psychiatry 61(Supp 13):3–11

    PubMed  Google Scholar 

  • McDonald WM, Thompson TR (2001) Treatment of mania in dementia with electroconvulsive therapy. Psychopharmacol Bull 35(2):72–82

    CAS  PubMed  Google Scholar 

  • McIntyre RS, Soczynska JK, Beyer JL, Woldeyohannes HO, Law CW, Miranda A, Konarski JZ, Kennedy SH (2007) Medical comorbidity in bipolar disorder: re-prioritizing unmet needs. Curr Opin Psychiatry 20(4):406–416

    Article  PubMed  Google Scholar 

  • Mendlewicz J, Fieve RR, Rainer JD, Fleiss JL (1972) Manic-depressive illness: a comparative study of patients with and without a family history. Br J Psychiatry 120:523–530

    Article  CAS  PubMed  Google Scholar 

  • Meyer JM (2002) A retrospective comparison of weight, lipid, and glucose changes between risperidone- and olanzapine-treated inpatients: metabolic outcomes after 1 year. J Clin Psychiatry 63(5):425–433

    Article  CAS  PubMed  Google Scholar 

  • Mirchandani IC, Young RC (1993) Management of mania in the elderly: an update. Ann Clin Psychiatry 5(1):67–77

    Article  CAS  PubMed  Google Scholar 

  • Mukherjee S, Sackeim HA, Schnur DB (1994) Electroconvulsive therapy of acute manic episodes: a review of 50 years’ experience. Am J Psychiatry 151(2):169–176

    Article  CAS  PubMed  Google Scholar 

  • Niedermier JA, Nasrallah HA (1998) Clinical correlates of response to valproate in geriatric inpatients. Ann Clin Psychiatry 10:165–168

    Article  CAS  PubMed  Google Scholar 

  • Noagiul S, Narayan M, Nelson CJ (1998) Divalproex treatment of mania in elderly patients. Am J Geriatr Psychiatry 6:257–262

    Article  Google Scholar 

  • Okuma T, Yamashita I, Takahashi R et al (1990) Comparison of the antimanic efficacy of carbamazepine and lithium carbonate by double-blind controlled study. Pharmacopsychiatry 23:143–150

    Article  CAS  PubMed  Google Scholar 

  • Oostervink F, Boomsma MM, Nolen WA (2009) Bipolar disorder in the elderly; different effects of age and age of onset. J Affect Disord 116:176–183

    Article  PubMed  Google Scholar 

  • Oostervink F, Nolen WA, Kik RM (2015) Two years’ outcome of acute mania in bipolar disorder: different effects of age and age of onset. Int J Geriatr Psychiatry 30:201–209

    Article  PubMed  Google Scholar 

  • Osby U, Brandt L, Correia N, Ekbom AA, Sparen P (2001) Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry 58(9):844–850

    Article  CAS  PubMed  Google Scholar 

  • Oshima A, Higuchi T (1999) Treatment guidelines for geriatric mood disorders. Psychiatry Clin Neurosci 53(Suppl 3):26S–31S

    Google Scholar 

  • Panjehshahin MR, Bowman CJ, Yates MS (1991) Effect of valproic acid, its unsaturated metabolites and same structurally related fatty acids on the binding of warfarin and dansylsacrosine to human albumin. Biochem Pharmacol 41:1227–1233

    Article  CAS  PubMed  Google Scholar 

  • Paton C, Barnes TRE, Shingleton-Smith A et al (2010) Lithium in bipolar and other affective disorders: prescribing practice in the UK. J Psychopharmacol 24:1739–1746

    Article  CAS  PubMed  Google Scholar 

  • Perlis RH (2005) The role of pharmacologic treatment guidelines for bipolar disorder. J Clin Psychiatry 66(Suppl 3):37–47

    CAS  PubMed  Google Scholar 

  • Petterson U (1977) Manic-depressive illness: a clinical, social and genetic study. Acta Psychiatr Scand 269:1–93

    Google Scholar 

  • Ponce H, Kunik M, Molinari V et al (1999) Divalproex sodium treatment in elderly male bipolar patients. J Geriatr Drug Ther 12:55–63

    Article  Google Scholar 

  • Posner J, Holdrich T, Crome P (1991) Comparison of lamotrigine pharmacokinetics in young and elderly healthy volunteers. J Pharm Med 1:121–128

    Google Scholar 

  • Post RM, Altshuler LL, Kupka R, McElroy SL, Frye MA, Rowe M, Grunze H, Suppes T, Keck PE Jr, Leverich GS, Nolen WA (2016) Age of onset of bipolar disorder: combined effect of childhood adversity and familial loading of psychiatric disorders. J Psychiatr Res 81:63–70

    Article  PubMed  Google Scholar 

  • Prien RF, Caffey EM, Klett CJ (1972) Relationship between serum lithium level and clinical response in acute mania treated with lithium. Br J Psychiatry 120:409–414

    Article  CAS  PubMed  Google Scholar 

  • Puryear LJ, Kunik ME, Workman R (1995) Tolerability of divalproex sodium in elderly psychiatric patients with mixed diagnoses. J Geriatr Psychiatry Neurol 8:234–237

    Article  CAS  PubMed  Google Scholar 

  • Reed RC, Dutta S (2006) Does it really matter when a blood sample for valproic acid concentration is taken following once-daily administration of divalproex-ER? Ther Drug Monit 28(3):413–418

    Article  CAS  PubMed  Google Scholar 

  • Regenold WT, Prasad M (2001) Uses of intravenous valproate in geriatric psychiatry. Am J Geriatr Psychiatry 9(3):306–308

    Article  CAS  PubMed  Google Scholar 

  • Roose SP, Bone S, Haidorfer C et al (1979) Lithium treatment in older patients. Am J Psychiatry 136:843–844

    Article  CAS  PubMed  Google Scholar 

  • Sachs GS (2003) Unmet clinical needs in bipolar disorder. J Clin Psychopharmacol 23(Suppl 1):S2–S8

    PubMed  Google Scholar 

  • Sajatovic M (2002) Treatment of bipolar disorder in older adults. Int J Geriatr Psychiatry 17(9):865–873

    Article  PubMed  Google Scholar 

  • Sajatovic M, Mullen J, Calabrese JR (2004) Quetiapine for the treatment of bipolar mania in older adults. Presented at the American Association of Geriatric Psychiatry, Baltimore, MD

    Google Scholar 

  • Sajatovic M, Madhusoodanan S, Coconcea N (2005a) Managing bipolar disorder in the elderly: defining the role of the newer agents. Drugs Aging 22(1):39–54

    Article  CAS  PubMed  Google Scholar 

  • Sajatovic M, Gyulai L, Calabrese JR, Thompson TR, Wilson BG, White R, Evoniuk G (2005b) Maintenance treatment outcomes in older patients with bipolar I disorder. Am J Geriatr Psychiatry 13(4):305–311

    Article  PubMed  Google Scholar 

  • Sajatovic M, Blow FC, Ignacio RV, Kales HC (2005c) New-onset bipolar disorder in later life. Am J Geriatr Psychiatry 13(4):282–289

    Article  PubMed  Google Scholar 

  • Sajatovic M, Blow FC, Ignacio RV (2006) Psychiatric comorbidity in older adults with bipolar disorder. Int J Geriatr Psychiatry 21:582–587

    Article  PubMed  Google Scholar 

  • Sajatovic M, Ramsay E, Nanry K, Thompson T (2007) Lamotrigine therapy in elderly patients with epilepsy, bipolar disorder or dementia. Int J Geriatr Psychiatry 22(10):945–950

    Article  PubMed  Google Scholar 

  • Sajatovic M, Coconcea N, Ignacio RV, Blow FC, Hays RW, Cassidy KA, Meyer WJ (2008) Aripiprazole therapy in 20 older adults with bipolar disorder: a 12-week, open-label trial. J Clin Psychiatry 69(1):41–46

    Article  CAS  PubMed  Google Scholar 

  • Sajatovic M, Gildengers A, Al Jurdi RK, Gyulai L, Cassidy KA, Greenberg RL, Bruce ML, Mulsant BH, Ten Have T, Young RC (2011) Multisite, open-label, prospective trial of lamotrigine for geriatric bipolar depression: a preliminary report. Bipolar Disord 13(3):294–302

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sajatovic M, Forester BP, Gildengers A, Mulsant BH (2013) Aging changes and medical complexity in late-life bipolar disorder: emerging research findings that may help advance care. Neuropsychiatry (London) 3(6):621–633

    Article  Google Scholar 

  • Sajatovic M, Dines P, Fuentes-Casiano E, Athey M, Cassidy KA, Sams J, Clegg K, Locala J, Stagno S, Tatsuoka C (2014) Asenapine in the treatment of older adults with bipolar disorder. Int J Geriatr Psychiatry 30(7):710–719

    Article  PubMed  PubMed Central  Google Scholar 

  • Schaffer CB, Garvey MJ (1984) Use of lithium in acutely manic elderly patients. Clin Gerontol 3:58–60

    Article  Google Scholar 

  • Shulman KI, Mackenzie S, Hardy B (1987) The clinical use of lithium carbonate in old age: a review. Prog Neuropsychopharmacol Biol Psychiatry 11:159–164

    Article  CAS  PubMed  Google Scholar 

  • Shulman KI, Tohen M, Satlin A, Mallya G, Kalunian D (1992) Mania compared with unipolar depression in old age. Am J Psychiatry 149(3):341–345

    Article  CAS  PubMed  Google Scholar 

  • Shulman RW, Singh A, Shulman KI (1997) Treatment of elderly institutionalized bipolar patients with clozapine. Psychopharmacol Bull 33(1):113–118

    CAS  PubMed  Google Scholar 

  • Shulman KI, Rochon P, Sykora K, Anderson G, Mamdani M, Bronskill S, Tran CT (2003) Changing prescription patterns for lithium and valproic acid in old age: shifting practice without evidence. BMJ 326(7396):960–961

    Article  PubMed  PubMed Central  Google Scholar 

  • Sibisi CDT (1990) Sex differences in the age of onset of bipolar affective illness. Br J Psychiatry 156:842–845

    Article  CAS  PubMed  Google Scholar 

  • Snowdon J (1991) A retrospective case-note study of bipolar disorder in old age. Br J Psychiatry 158:485–490

    Article  CAS  PubMed  Google Scholar 

  • Spicer CC, Hare EH, Slater E (1973) Neurotic and psychotic forms of depressive illness: evidence from age-incidence in a national sample. Br J Psychiatry 123:535–541

    Article  CAS  PubMed  Google Scholar 

  • Sproule BA, Hardy BG, Shulman KI (2000) Differential pharmacokinetics of lithium in elderly patients. Drugs Aging 16(3):165–177

    Article  CAS  PubMed  Google Scholar 

  • Starkstein SE, Robinson RG (1989) Affective disorders and cerebral vascular disease. Br J Psychiatry 154:170–182

    Article  CAS  PubMed  Google Scholar 

  • Starkstein SE, Robinson RG, Price TR (1987) Comparison of cortical and subcortical lesions in the production of post-stroke mood disorders. Brain 110:1045–1059

    Article  PubMed  Google Scholar 

  • Starkstein SE, Mayberg HS, Berthier ML, Fedoroff P, Price TR, Dannals RF, Wagner HN, Leiguarda R, Robinson RG (1990) Mania after brain injury: neuroradiological and metabolic findings. Ann Neurol 27(6):652–659

    Article  CAS  PubMed  Google Scholar 

  • Starkstein SE, Fedoroff P, Berthier ML, Robinson RG (1991) Manic-depressive and pure manic states after brain lesions. Biol Psychiatry 29(2):149–158

    Article  CAS  PubMed  Google Scholar 

  • Steffens DC, Krishnan KR (1998) Structural neuroimaging and mood disorders: recent findings, implications for classification, and future directions. Biol Psychiatry 43(10):705–712

    Article  CAS  PubMed  Google Scholar 

  • Stenstedt A (1952) Study in manic-depressive psychosis: clinical, social, and genetic investigations. Acta Psychiatr Neurol Scand Suppl 79:1–111

    Google Scholar 

  • Stone K (1989) Mania in the elderly. Br J Psychiatry 155:220–224

    Article  CAS  PubMed  Google Scholar 

  • Street J, Tollefson GD, Tohen M et al (2000) Olanzapine for the psychotic conditions in the elderly. Psychiatr Ann 30(3):191–196

    Article  Google Scholar 

  • Subramaniam H, Dennis MS, Byrne EJ (2007) The role of vascular risk factors in late onset bipolar disorder. Int J Geriatr Psychiatry 22(8):733–737

    Article  PubMed  Google Scholar 

  • Tamashiro JH, Zung S, Zanetti MV, de Castro CC, Vallada H, Busatto GH, de Toledo Ferraz Alves TC (2008) Increased rates of white matter hyperintensities in late-onset bipolar disorder. Bipolar Disord 10(7):765–775

    Article  PubMed  Google Scholar 

  • Taylor MA, Abrams R (1973) Manic states: a genetic study of early and late onset affective disorders. Arch Gen Psychiatry 28:656–658

    Article  CAS  PubMed  Google Scholar 

  • Tohen M, Shulman KI, Satlin A (1994) First-episode mania in late life. Am J Psychiatry 151(1):130–132

    Article  CAS  PubMed  Google Scholar 

  • Tredget J, Kirov A, Krov G (2010) Effects of chronic lithium treatment on renal function. J Affect Disord 126:436–440

    Article  CAS  PubMed  Google Scholar 

  • Tsao CI, Jain S, Gibson RH, Guedet PJ, Lehrmann JA (2004) Maintenance ECT for recurrent medication-refractory mania. J ECT 20(2):118–119

    Article  PubMed  Google Scholar 

  • Tueth MJ, Murphy TK, Evans DL (1998) Special considerations: use of lithium in children, adolescents, and elderly populations. J Clin Psychiatry 59(Suppl 6):66–73

    CAS  PubMed  Google Scholar 

  • Umapathy C, Mulsant BH, Pollock BG (2000) Bipolar disorder in the elderly. Psychiatr Ann 30:473–480

    Article  Google Scholar 

  • Unutzer J, Simon G, Pabiniak C, Bond K, Katon W (1998) The treated prevalence of bipolar disorder in a large staff-model HMO. Psychiatr Serv 49(8):1072–1078

    Article  CAS  PubMed  Google Scholar 

  • Valentí M, Benabarre A, García-Amador M, Molina O, Bernardo M, Vieta E (2008) Electroconvulsive therapy in the treatment of mixed states in bipolar disorder. Eur Psychiatry 23(1):53–56

    Article  PubMed  Google Scholar 

  • van der Velde CD (1970) Effectiveness of lithium carbonate in the treatment of manic-depressive illness. Am J Psychiatry 123:345–351

    Article  Google Scholar 

  • Van Gerpen MW, Johnson JE, Winstead DK (1999) Mania in the geriatric patient population: a review of the literature. Am J Geriatr Psychiatry 7(3):188–202

    Article  PubMed  Google Scholar 

  • Weissman MM, Leaf PJ, Tischler GL, Blazer DG, Karno M, Bruce ML, Florio LP (1988) Affective disorders in five United States communities. Psychol Med 18(1):141–153

    Article  CAS  PubMed  Google Scholar 

  • Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, Joyce PR, Karam EG, Lee CK, Lellouch J, Lepine JP, Newman SC, Rubio-Stipec M, Wells JE, Wickramaratne PJ, Wittchen H, Yeh EK (1996) Cross-national epidemiology of major depression and bipolar disorder. JAMA 276(4):293–299

    Article  CAS  PubMed  Google Scholar 

  • Wijeratne C, Malhi GS (2007) Vascular mania: an old concept in danger of sclerosing? A clinical overview. Acta Psychiatr Scand Suppl 434:35–40

    Article  Google Scholar 

  • Wilkins KM, Ostroff R, Tampi RR (2008) Efficacy of electroconvulsive therapy in the treatment of nondepressed psychiatric illness in elderly patients: a review of the literature. J Geriatr Psychiatry Neurol 21(1):3–11

    Article  PubMed  Google Scholar 

  • Winokur G (1975) The Iowa 500: heterogeneity and course in manic-depressive illness (Bipolar). Comp Psychiatry 16(2):125–131

    Article  CAS  Google Scholar 

  • Wylie M, Mulsant B, Pollock B et al (1999) Age at onset in geriatric bipolar disorder. Am J Geriatr Psychiatry 7:77–83

    CAS  PubMed  Google Scholar 

  • Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, O’Donovan C, Macqueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Milev R, Bond DJ, Frey BN, Goldstein BI, Lafer B, Birmaher B, Ha K, Nolen WA, Berk M (2013) Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society forBipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disord 15(1):1–44

    Article  CAS  PubMed  Google Scholar 

  • Young RC, Kalayam B, Tsuboyama G et al (1992) Mania: response to lithium across the age spectrum (abstract). Soc Neurosci 18:669

    Google Scholar 

  • Young RC, Gyulai L, Mulsant BH, Flint A, Beyer JL, Shulman KI, Reynolds CF III (2004) Pharmacotherapy of bipolar disorder in old age: review and recommendations. Am J Geriatr Psychiatry 12(4):342–357

    Article  PubMed  Google Scholar 

  • Young RC, Schulberg HC, Gildengers AG, Sajatovic M, Mulsant BH, Gyulai L, Beyer J, Marangell L, Kunik M, Ten Have T, Bruce ML, Gur R, Marino P, Evans JD, Reynolds CF III, Alexopoulos GS (2010) Conceptual and methodological issues in designing a randomized, controlled treatment trial for geriatric bipolar disorder: GERI-BD. Bipolar Disord 12(1):56–67

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zis AP, Grof P, Goodwin FK (1979) The natural course of affective disorders: Implications for lithium prophylaxis. In: Cooper TB, Gershon S, Kline NS, Shou M (eds) Lithium: controversies and unsolved issues. Exerpta Medica, Amsterdam, pp 381–398

    Google Scholar 

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Authors and Affiliations

  1. Duke University Medical Center, Box 3519 DUMC, Durham, NC, 27710, USA

    John L. Beyer MD

  2. Dean Rush Medical College, Rush University Medical Center, Chicago, IL, USA

    K. Ranga R. Krishnan MD

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Correspondence to John L. Beyer MD .

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  1. Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA

    Carlos A. Zarate Jr.

  2. Janssen Pharmaceuticals of Johnson and Johnson, Janssen Research and Development, Titusville, New Jersey, USA

    Husseini K. Manji

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Beyer, J.L., Krishnan, K.R.R. (2016). Treatment of Bipolar Disorder in Special Populations. In: Zarate Jr., C., Manji, H. (eds) Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis, and Pharmacotherapy. Milestones in Drug Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-31689-5_13

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