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Bipolar disorder in the elderly; different effects of age and of age of onset
Journal of Affective Disorders, 06/25/09

Oostervink F et al. - Elderly bipolar manic patients differ from younger bipolar manic patients regarding treatment but not treatment outcome. LOB elderly patients demonstrated a more favourable outcome. The use of medication and the occurrence of rapid cycling in EOB elderly patients warrant further study.

Methods

The European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) study was a 2-year prospective, observational study in 3459 bipolar patients on the treatment and outcome of patients with an acute manic or mixed episode.
Within this study, elderly patients (> 60 years of age; n = 475) were compared with younger patients (< 50 years of age; n = 2286), and within the elderly group, Late Onset Bipolar (LOB) patients (onset ≥ 50 years; n = 141) were compared with Early Onset Bipolar (EOB) patients (< 50 years; n = 323).

Results

In the year prior to enrolment, elderly patients, especially those with EOB, more frequently reported a rapid cycling course of illness, but fewer suicide attempts.
At baseline, elderly patients more often used one psychotropic medication and demonstrated less severe manic and psychotic symptoms, but no difference in depressive symptomatology.
However, prior to enrolment and during the acute phase of treatment, elderly patients more frequently received antidepressants.
Atypical antipsychotics were given less frequently.
Regarding 12-week outcomes, there was no difference between elderly and younger patients, although LOB elderly recovered faster, and were discharged sooner than EOB elderly patients.

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