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EPA-1620 – The Challenge of Treating Bipolar Disorder in Elderly People

Published online by Cambridge University Press:  15 April 2020

R. Navarro ,
O. Santamaria  and
F. Gotor
R. Navarro
Affiliation:
Psychiatry, Nuestra Señora de Valme University Hospital, Seville, Spain
O. Santamaria
Affiliation:
Psychiatry, Nuestra Señora de Valme University Hospital, Seville, Spain
F. Gotor
Affiliation:
Psychiatry, Nuestra Señora de Valme University Hospital, Seville, Spain

Abstract

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Background

Bipolar affective disorder in the elderly is a complex entity not only in its clinical dimension but also in its therapeutic management. Elderly patients are very sensitive to pharmacological secondary effects.

The objective of this study is to longitudinally analyze the pharmacological route of a sample of outpatients above 65 years old.

Method

Review of clinical histories and data collection from a sample of 12 patients over 65 years old.

Results

 Current ageYears of evolutionSomatic backgroundPrevious treatmentCause of modificationCurrent treatmentSide effets
N17959Arrhythmia, high blood pressureLithiumRenal failuregabapentineTremor, drowssiness
N27660CholecistectomyHaloperidol, lithium biperiden, zolpidemExtrapyramidal syndromeLithium, trazodone, lorazepamDistal tremor, cognitive impairment
N37225Ischemic heart disease, high blood pressure, VHB. Essential tremor, cognitive impairmentFluoxetine, lamotrigineInefectiveQuetiapine, valproic acidWorsening Cognitive impairment, drowsiness
   OxcarbazepineNeutropenia
   HaloperidolExtrapyramidal syndrome
   olanzapineGain Weigth
N46838Diabetes mellitusTryciclic antidepressants, valproic acid, lithiumDrowsiness, gastric discomfort, fatigueRisperidone, zolpidemTremor, dependence on zolpidem

Conclusions

Most of the patients experienced at least three drugs prior to their current treatment. The fundamental reason for changes were intolerable adverse effects and, in one of them, irreversible (kidney failure). The trend is to replace drugs by atypical antipsychotic or antiepileptic ones. The prescription of gabapentin is not based on scientific evidence but with a positive response. The available literature is still limited to justify these decisions based on clinical experience, somatic background and tolerance of the patient.

Type
P03 - Bipolar Disorders
Information
European Psychiatry , Volume 29 , Issue S1: Abstracts of the 22nd European Congress of Psychiatry , 2014 , pp. 1
Copyright
Copyright © European Psychiatric Association 2014
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