BIPOLAR MOOD DISORDERS IN THE ELDERLY

Patients with manic episodes represent a substantial subgroup among el derly with mood disorders. Although the incidence of mania declines ac ross the life span, it may increase again in certain subgroups of the elderly. For example, late age at onset is often associated with medic al and neurologic illness and drug treatments. Age effects on phenomen ology and course have received only preliminary investigation. Manic e pisodes in late Life may be heterogeneous in terms of representing sim ply the recurrence of young adult-onset bipolar disorder in late life, the new onset of a bipolar disorder, or a late-onset manic episode in a patient with a history of major depression. Although aging, disease s, and drug treatments can alter pharmacokinetics and pharmacologic re actions, Lithium and more recently the anticonvulsant valproate acid c an be useful in acute, continuation, and maintenance treatment of geri atric mania.