Tratamento do transtorno bipolar no idoso: uma revisão da literatura

Bipolar disorder (BAD) is a potentially severe condition characterized by mood shifts and cognitive and functional dysfunction. This article reviews updated evidence on the pharmacological and non-drug interventions for BD in the elderly. Evidence-based guidelines, although useful in promoting rational and effective therapy, are still relatively scarce for BD in aged individuals. Current recommendations for acute mania include the use ofatypical antipsychotics (e.g., risperidone, quetiapine, olanzapine), lithium (with judicious administration), and the choice of valproate as a gold standard therapy. In acute BD depression, first-line monotherapy agents may include lithium, lamotrigine, quetiapine, and extendedrelease quetiapine (XR). Regarding the choice of the ideal mood stabilizer, the greater potential for side effects associated with lithium has discouraged its prescription in elderly individuals. Electroconvulsive therapy, although limited by the evidence available, may be an option for severe/refractory cases.