Publication details
Bipolární porucha u starší populace
| Title in English | Bipolar disorder in elderly population |
|---|---|
| Authors | |
| Year of publication | 2007 |
| Type | Article in Periodical |
| Magazine / Source | Česká geriatrická revue |
| MU Faculty or unit | |
| Citation | |
| Field | Psychiatry, sexuology |
| Keywords | bipolar disorder; elderly patients; efficacy; tolerability; safety; lithium; valproate; carbamazepine; antidepressants; atypical antipsychotics |
| Description | Briefly a topic of bipolar disorder, including data concerning elderly population, is summarised. Attention is paid to the clinical picture and differential diagnostics associated with gerontopsychiatrie patients. Especially the possibility of secondary mania based on organic brain impairment and risk of suicidal behaviour is mentioned. The treatment efficacy is the same in both elderly and yonger populations, bud elderly patients are more sensitive to treatment efficacy and side effects. Some special treatment characteristics of individual drugs, in elderly patients are reviewed. In both acute and maintenance treatment lithium is a first-choice drug, however decreased lithium clearence must be taken into consideration and the rule of slow titration and lower doses must be kept. In bipolar depression, specific serotonin re-uptake inhibitors and other antidepressants with minimal anticholinergic and cardiovascular side effects (bupropion) are preferred. Further possibilities include atypical antipsychotics. Generally, the safety should be placed first when choosing treatment for elderly patients. |
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