Late onset mania as an organic syndrome: A review of case reports in the literature

Sami, Musa; Khan, Hina; Nilforooshan, Ramin

doi:10.1016/j.jad.2015.08.027

Cited by 56 publications

(19 citation statements)

References 53 publications

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“…Although the psychopathologic manifestations of mania are similar in the elderly and in younger bipolar patients, both the etiology and the response to treatment are extremely variable. Recent data support the hypothesis that in older patients the onset of BD may be related to neurologic or vascular diseases 13. Many neuroimaging studies have shown brain atrophy and cerebrovascular lesions in patients with BD 14…”

Section: Introductionmentioning

confidence: 67%

Lithium in late-life mania: a systematic review

Fazio¹,

Gaetano²,

Caroleo³

et al. 2017

NDT

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The prevalence of mania among >65-year-olds ranges from 0.1% to 0.4% and its treatment is a particular challenge for clinicians. Although lithium is the treatment of choice for bipolar disorder (BD), its use in elderly population was recently questioned. This study provides a comprehensive review of literature on the efficacy and tolerability of lithium as a pharmacologic treatment for mania in elderly BD patients. We conducted a systematic review, based on PRISMA guidelines, of articles published between 1970 and August 2016 and indexed in the following databases: EMBASE, MEDLINE, Cochrane Library Databases and PsycINFO. The key words “age”, “late-life”, “geriatric”, “elderly”, and “older” were combined with words indicating pharmacologic treatments, such as lithium and other mood stabilizers and with the diagnostic terms “bipolar disorder” and “mania”. Fifteen out of 196 retrieved studies met our inclusion criteria. Seven studies evaluated both the efficacy and tolerability of lithium treatment in elderly BD patients; a further three evaluated only the efficacy and five assessed tolerability. Only limited data on the treatment of elderly BD patients are available, but evidence suggests that lithium is effective and tolerated in this subgroup of patients and thus should remain a first-line drug. It seems to be more effective at lower doses and close monitoring of plasma concentrations is necessary.

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Section: Introductionmentioning

confidence: 67%

Lithium in late-life mania: a systematic review

Fazio¹,

Gaetano²,

Caroleo³

et al. 2017

NDT

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“…The pathophysiology of late onset bipolar disorder is thought to be different from early onset bipolar disorder with the late onset group having higher rates of neurologic and vascular brain abnormalities (Young and Klerman, 1992;Tohen et al, 1994;Fujikawa et al, 1995;Sami et al, 2015). Vascular mania has been suggested as a subtype of secondary mania, when it occurs in the presence of co-morbid cerebrovascular disease or cognitive impairment (Steffens and Krishnan, 1998;Sajatovic et al, 2015).…”

Section: Elation Euphoria and Maniamentioning

confidence: 99%

Affective and emotional dysregulation as pre-dementia risk markers: exploring the mild behavioral impairment symptoms of depression, anxiety, irritability, and euphoria

Ismail

Gatchel

Bateman

et al. 2017

Int. Psychogeriatr.

169

109

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Affective symptoms are of prognostic utility, but interventions to prevent dementia syndromes are limited. Trials need to assess interventions targeting known dementia pathology, toward novel pathology, as well as using psychiatric medications. Research focusing explicitly on later life onset symptomatology will improve our understanding of the neurobiology of NPS and neurodegeneration, enrich the study sample, and inform observational and clinical trial design for prevention and treatment strategies.

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“…A review of case reports with a first manic episode occurring above the age of 50, shows that this is in the majority of cases has an organic basis, which requires thorough somatic and psychiatric screening [5].…”

Section: Discussionmentioning

confidence: 99%

Late-Onset Manic Episode after Bariatric Surgery

2019

IJP

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A manic episode is a clearly recognizable period with an abnormally and persistently elevated, expansive or irritable mood, with an abnormal and persistently increased targeted activity of energy, present for a week and during the biggest part of the day [1]. The episode usually fits within a bipolar disorder, in which also depressive episodes occur. These episodes often precede the manic phase. When a first manic episode occurs at a later age without any personal history, a somatic cause must always be excluded. Lateonset mania is associated with increased somatic comorbidity in patients aged 50 years and older. [2]

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Late onset mania as an organic syndrome: A review of case reports in the literature

Cited by 56 publications

References 53 publications

Lithium in late-life mania: a systematic review

Lithium in late-life mania: a systematic review

Affective and emotional dysregulation as pre-dementia risk markers: exploring the mild behavioral impairment symptoms of depression, anxiety, irritability, and euphoria

Late-Onset Manic Episode after Bariatric Surgery

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