Update on the Epidemiology, Diagnosis, and Treatment of Mania in Older-Age Bipolar Disorder
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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.
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.
KeywordsMania Elderly Geriatric Bipolar disorder Manic-depressive disorder Mood stabilizers
Compliance with Ethical Standards
Conflict of Interest
Peijun Chen, Annemiek Dols, and Soham Rej each declare no potential conflicts of interest.
Martha Sajatovic has received grant support from Alkermes, Janssen, Pfizer, and Merck and royalties from Springer Press, Johns Hopkins University Press, and Oxford Press and served as consultant for Bracket, Pfizer, Otsuka, Sunovion, Neurocrine, Supernus, and Health Analytics.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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