Changing prescription patterns for lithium and valproic acid in old age: shifting practice without evidence

Evidence-Based Pharmacological Treatment of Geriatric Bipolar Disorder

“…LI has been widely prescribed in the elderly [14,15]. Among communitybased BP patients from Western Pennsylvania in the late 1990s, close to two thirds of those over the age of 65 were treated with LI, and only 31% were receiving anticonvulsants; the proportion of older patients treated with LI was significantly higher than the proportion of younger patients [14].…”

“…Divalproex sodium is more commonly prescribed than valproic acid. In the province of Ontario, VAL has surpassed LI salts as a new prescription for elderly patients with a mood disorder [15]. Table 1 lists six reports concerning VAL in elderly patients that included examination of side effects.…”

Lamotrigine therapy in elderly patients with epilepsy, bipolar disorder or dementia

“…Available treatment guidelines do not provide specific recommendations for treatment of older adults with BD (Van Gerpen et al, 1999;Sajatovic, 2002a) and it is common for health services studies in BD to focus on younger populations (Russo et al, 2002). Anticonvulsant medications have supplemented the use of lithium therapy in older adults with BD (Shulman et al, 2003); while specifics regarding use remain to be clarified (Sajatovic, 2002b;Charney et al, 2003).…”

Lithium activates brain phospholipase A2 and improves memory in rats: implications for Alzheimer’s disease

“…Lithium salts have been used for decades as the drug of choice in the treatment of manic-depressive episodes and as a mood stabilizer in patients with bipolar disorder (BPD) [1][2][3][4]. Clinical benefits derived from lithium treatment comprise acute anti-manic, antidepressant and long-term Abstract Phospholipase A2 (Pla2) is required for memory retrieval, and its inhibition in the hippocampus has been reported to impair memory acquisition in rats.…”