Late-onset bipolar disorder

Abstract

Much is still unknown about late-life bipolar disorder (BPD), especially late-onset BPD. Late-onset BPD may be etiologically different from early-onset BPD, and may be related to the medical and neurological problems that can occur with aging; alternately, it may be an underlying progression of neurological illness associated with certain cases of BPD early in life. Treatment of late-life BPD requires knowledge of 'best treatment' practices and an understanding of the effect aging has on psychopharmacotherapy. This chapter discusses the various treatment options available to this population. These include the mood stabilizers (e.g., lithium) and anticonvulsants (e.g., valproate, lamotrigine) most often used to treat BPD, as well as alternative treatments such as atypical antipsychotics and ECT. However, adequate clinical trials that would provide good evidence-based treatment recommendations for late-life BPD are not currently available. Therefore, extrapolation from trials in mixed-age populations and adaptation to the older patient is necessary to establish treatment recommendations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)