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Current Psychiatry Reports
Published in: Current Psychiatry Reports 6/2011

01-12-2011 | Bipolar Disorders (David S. Janowsky, Section Editor)

Use of Lithium in the Treatment of Bipolar Disorder in Late-Life

Authors: Ramsey D’Souza, Tarek K. Rajji, Benoit H. Mulsant, Bruce G. Pollock

Published in: Current Psychiatry Reports | Issue 6/2011

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Abstract

Lithium is the oldest and still one of the most frequently prescribed mood stabilizers in the treatment of bipolar disorder. Nonetheless, the evidence for lithium efficacy in older patients with bipolar disorder is almost entirely extrapolated from younger adult patients. Here we review the literature on lithium in older patients with bipolar disorder, concentrating on the past 3 years. A definitive study demonstrating the efficacy and safety of lithium in older patients with bipolar disorder is still missing. However, several lines of indirect evidence suggest that it is beneficial and advantageous over other mood stabilizers in the acute and maintenance treatment of late-life bipolar disorder. In addition, lithium may have unique properties as a regenerative therapeutic with specific benefits in reducing the cognitive impairment and suicide rates associated with bipolar disorder across the adult lifespan. Aging-associated pharmacokinetic and pharmacodynamic changes as well as increased rates of medical comorbidities and polypharmacy predispose older patients to a higher risk of lithium toxicity. Careful monitoring and adjustment of lithium dosage is especially important in older adults to minimize the risk of toxicity.
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Metadata
Title
Use of Lithium in the Treatment of Bipolar Disorder in Late-Life
Authors
Ramsey D’Souza
Tarek K. Rajji
Benoit H. Mulsant
Bruce G. Pollock
Publication date
01-12-2011
Publisher
Current Science Inc.
Published in
Current Psychiatry Reports / Issue 6/2011
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-011-0228-9

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