The clinical use of lithium carbonate in old age: A review

Shulman, Kenneth I.; Mackenzie, Susan; Hardy, Billie-Jo

doi:10.1016/0278-5846(87)90054-6

Cited by 39 publications

(13 citation statements)

References 23 publications

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“…Unfortunately, few systematic studies exist that address the efficacy of lithium in this age group [Foster, 1992;Shulman et al, 1987;Young and Klerman, 1992], especially since several clinical variables in older adults (dementia, organic disorders, and comorbid medical conditions) may be associated with a poor response to lithium [Sproule et al, 2000;Young and Klerman, 1992].…”

Section: Introductionmentioning

confidence: 99%

Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation

et al. 2007

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Affective disorders are a major cause of morbidity and disability among middle-aged and older people. Thus, the prophylaxis of both unipolar depression and bipolar disorder in this patient subpopulation is an important task of psychiatrists and other physicians. Although lithium remains an effective prophylactic and treatment agent in younger individuals with bipolar disorder, its prophylactic efficacy and tolerability has not been thoroughly investigated among middle aged and older people with unipolar depression and bipolar disorder. Our study is based on a mirror-image design that compared the clinical course with lithium treatment and the clinical course prior to lithium treatment based on a retrospective chart review. We examined the results obtained with long-term lithium maintenance in a group of 60 middle-aged and older adult patients (age >60 years) with unipolar depression and bipolar disorder. More specifically, we analyzed changes of frequency, severity, and duration of depressive or manic relapses, rate and duration of hospitalizations and suicidal behavior (thoughts or attempts), and various assessments of outcome. A significant reduction was found on all indices during lithium therapy compared to before lithium treatment, attesting to the prophylactic efficacy of long-term lithium in unipolar depression and bipolar disorder. The range of side effects in our sample was similar to that found in other reports in this age group. The probability of relapse and recurrence in patients with bipolar disorder and with unipolar depression can be significantly decreased by lithium prophylaxis. Further investigation is mandated to confirm these findings under double-blind conditions.

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Section: Introductionmentioning

confidence: 99%

Lithium therapy for unipolar and bipolar depression among the middle-aged and older adult patient subpopulation

et al. 2007

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“…In this cohort the mean serum lithium level of the group was 0.42 mmol/l (SD 0.12), which is slightly lower than a recommended serum level for lithium use in old age (Shulman et al, 1987) of approximately 0.5 mmol/l (using a single bedtime dosing regimen). However, the mean serum lithium level was higher in those with bipolar affective disorder (0.5 mmol/l) than those with unipolar depression (0.39 mmol/l), as might be expected.…”

Section: Discussionmentioning

confidence: 83%

Lithium use in octogenarians

Fahy

Lawlor

2001

Int J Geriat Psychiatry

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“…Therefore, it is especially appropriate to consider secondary mania in an elderly patient who has new-onset mania. According to Shulman et al [3], the elderly are twice as likely to have a neurological disorder as patients with prior episodes of mania [3]. There also appears to be a bimodal distribution of bipolar illness for women and an increased incidence of mania in old age for men [4].…”

Section: Clinical Presentationmentioning

confidence: 98%