A Comprehensive Review of the Evaluation, Diagnosis, and Treatment of Older Adult Bipolar Disorder

AbstractPurpose of reviewThis review summarizes the extant literature on the epidemiology, neuropsychology, clinical assessment, and treatment/management of older adult bipolar disorder (OABD). The primary aim was to provide a contemporary and accessible reference for clinicians involved in the care of OABD patients.Recent findingsImportant research into the unique features of OABD has been carried out in recent years, providing a more robust albeit still limited foundation to help guide clinical decision-making. Some of the more consistent findings have highlighted (1) the importance of assessing for potentially reversible sources of secondary mania (i.e., manic symptoms unrelated to a primary mood disorder but with qualitatively similar presentation) in patients with late-onset mania; (2) the need for closer follow-up and more aggressive treatment to help stabilize illness course in OABD patients with earlier symptom onset; (3) the presence of domain-general cognitive dysfunction (but not accelerated cognitive aging) in OABD; and (4) the strong need for more randomized control trials examining the safety and efficacy of various psychopharmacological interventions in OABD samples. Research continues to support lithium as the gold-standard treatment for OABD, but there are other promising therapies. Asenapine, lurasidone, and divalproex have demonstrated efficacy in reducing symptoms, but future research must also categorize their side effect profile and most effective use in...
Source: Current Treatment Options in Psychiatry - Category: Psychiatry Source Type: research