ASSESSMENT AND TREATMENT OF BIPOLAR DISORDER IN THE ELDERLY

The aetiology of late-onset bipolar disorder is heterogeneous because the disease is more likely to have a secondary (i.e. a medical disorde r or medication-induced) cause in older than in younger patients. Elde rly patients with bipolar disorder typically require lithium dosages t hat are 25 to 50% lower than those used in younger individuals. Inform ation on the use of valproic acid (sodium valproate) in elderly patien ts with bipolar disorder is limited but encouraging. In contrast. ther e is virtually no information regarding the use of carbamazepine or ot her drugs in this patient group. Electroconvulsive therapy is well tol erated by older people and can be useful for these patients.