Treatment of bipolar disorders in older adults: a review

Table 3 Summary of the evidence for frequently used medication, physical treatments and psycho/psychosocial therapies in old age BD

Treatment	Mania	Bipolar depression	Maintenance	Notes
Lithium	+	0	+	For mania: EP-ABD, [70]; For maintenance: LGE
Valproate	+	0	0	For mania: LGE
Lamotrigine	–	+	+	For depression and maintenance: LGE
Antipsychotics	+	0	0	For mania: LGE for quetiapine, asenapine, risperidone, aripiprazole, clozapine For depression and maintenance: EP-ABD
Antidepressants	–	0	0	For depression and maintenance: EP-ABD
ECT	+	+	0	All EP-ABD or trials in geriatric unipolar depressed patients
Psychotherapy and psychosocial treatment	–	+	+	EP-ABD or LGE

The grading is based on the evidence reported in this review and only reflects the opinion and judgement of the authors
Grade of recommendation: +: recommended, 0: conflicting evidence or unfavourable risk/benefits ratio; may be considered in selected patients, –: not recommended
EP-ABD: Extrapolated from controlled studies in 18–65 year-old adult BD patients
LGE: Low grade evidence such as post hoc analysis, open studies, retrospective chart reviews
[..] Reference to controlled study in old age BD

ISSN: 1744-859X