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Antidepressant-associated mania in late life
R C Young1, H Jain, D N Kiosses
1Department of Psychiatry, Weill Medical College of Cornell University, USA. ryoung@med.cornell.edu
International Journal of Geriatric Psychiatry
|May 27, 2003
Summary
Elderly patients experiencing first-episode mania, particularly those treated with antidepressants, show later age of onset. Antidepressant-associated mania (AAM) in older adults warrants further study.
Area of Science:
- Geriatric Psychiatry
- Pharmacopsychiatry
- Neuroscience
Background:
- Late-life mania can be a first presentation in elderly patients.
- Antidepressant use in elders may trigger manic episodes.
- Clinical features of antidepressant-associated mania (AAM) in late life are understudied.
Purpose of the Study:
- Identify elderly patients with AAM.
- Compare clinical characteristics of AAM patients to non-AAM patients.
- Investigate the hypothesis that AAM patients have a later age of bipolar disorder onset.
Main Methods:
- Retrospective review of geriatric inpatients (age >= 60) with manic disorder.
- Sample selected from admissions prior to 1990.
- Comparison between patients treated with antidepressants and those not.
Main Results:
- AAM patients (n=11) were more likely to have their first manic episode.
- AAM patients exhibited a later age of onset for their first manic episode compared to non-AAM patients (n=46).
- Tricyclic antidepressants were the most common agents used in AAM patients.
Conclusions:
- Preliminary findings suggest AAM in the elderly is associated with a later age of onset.
- Further research is needed to analyze risks and benefits of antidepressants in geriatric populations.
- Late-life first-episode mania may serve as a model for understanding AAM vulnerability.