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Sajatovic, M. et al.

Sajatovic, Gyulai, Calabrese, Thompson, Wilson, White, Evoniuk,

Maintenance treatment outcomes in older patients with bipolar I disorder.

OBJECTIVE: The efficacy and tolerability of mood stabilizers in older adults with bipolar disorder remains understudied. Authors retrospectively examined response to lamotrigine, lithium, and placebo in older (>or=age 55) adults with Bipolar I disorder (DSM-IV) who participated in two mixed-age, maintenance studies examining time to intervention for an emerging mood episode (manic/hypomanic/mixed or depressed) and drug tolerability. METHODS: In all, 588 patients received double-blind lamotrigine (LTG, 100 mg-400 mg/day), lithium (Li, 0.8 mEq/L-1.1 mEq/L), or placebo (PBO); data from 98 older adults (LTG: 33, Li: 34, PBO: 31) were examined. Mean modal total daily doses were LTG 240 mg and Li 750 mg. RESULTS: LTG significantly delayed time to intervention for any mood episode and for a depressive episode, compared with placebo. Li significantly delayed time to intervention for mania/hypomania/mixed compared with placebo. Back pain and headache were the most common adverse events during LTG treatment; rash: LTG, 3%; Li, 6%; and PBO, 0; no serious rash was reported. The most common adverse events (>10%) during lithium treatment were dyspraxia, tremor, xerostomia, headache, infection, amnesia, dizziness, diarrhea, nausea, and fatigue. CONCLUSION: Lamotrigine and lithium may be effective and well-tolerated maintenance therapies for older adults with Bipolar I depression.[1]

References

Maintenance treatment outcomes in older patients with bipolar I disorder. Sajatovic, M., Gyulai, L., Calabrese, J.R., Thompson, T.R., Wilson, B.G., White, R., Evoniuk, G. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. (2005) [Pubmed]

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