Pharmacological Treatment of Bipolar Disorder in the Elderly

Autor: Joanna Georgakas, Tamar C. Katz, Brent P. Forester, William Quayle, Claire Motyl
Rok vydání: 2017
Předmět:
Zdroj: Current Treatment Options in Psychiatry. 4:13-32
ISSN: 2196-3061
DOI: 10.1007/s40501-017-0101-5
Popis: Due to the early age of onset, bipolar disorder is most commonly studied in younger adults, among whom the prevalence is 3.9% in adults aged 18–30 years. Unfortunately, relatively less attention has been paid to the unique needs of older adults with bipolar disorder (OABD), despite clinical complexities that include medical comorbidity, polypharmacy, cognitive decline, and phase of life losses of occupation and social identity. Furthermore, impaired cognitive performance in some older adults may limit the ability to stabilize mood episodes and interfere with the individual’s engagement in multi-modal treatment. Many OABD may also struggle with impairments in their independent activities of daily living (IADLs) which can lead to greater psychiatric, medical, psychological, financial, or social sequelae of mood episodes. Further complicating this picture is the fact that most OABD are treated by general psychiatrists or family practitioners due to a worldwide shortage of geriatric psychiatrists. This will become increasingly common as the mean life expectancy continues to increase. It is therefore incumbent on all general practitioners to understand the phases of bipolar disorder and the associated treatment options throughout the lifespan. Treatment of manic or depressive episodes focuses on symptomatic remission primarily through pharmacotherapy and neurotherapeutics. Management of the maintenance phase focuses on optimizing pharmacotherapy while reducing subclinical symptoms, treating comorbid illness, preventing relapse, and restoring psychosocial functioning and intacts identity through multimodal approaches including psychopharmacology, psychotherapy, diet, and lifestyle modifications. Comprehensive care for OABD is best achieved through close collaboration with the affected individual, the family physician, pharmacist, family members, and social supports.
Databáze: OpenAIRE
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