Evaluating Pharmacological Treatment Options in Elderly Patients With Bipolar Disorder Who Admitted to a University Hospital

Abstract

Objective: The aim of the present study is to evaluate pharmacological treatment options, common side effects and treatment compliance in elderly patients with type I Bipolar Disorder (BD) in the light of current literature. Method: The study sample (n=99) consisted of elderly patients (≥65 years old) who admitted to the psychiatry clinic of a university hospital between 2006-2011 and had the diagnosis of BD type-1. The patient files were examined and psychotropic agents which were used in the last visit were taken into account. Common side effects and treatment compliance were also evaluated. Results: Mood stabilisers (MS) were used by 74.4% of the patients, followed by second generation antipsychotics (SGAP) (71.7%), hypnotic-sedative andantidepressants (%27.2). Most commonly used MS were lithium (37.4%) and valproic acid (36.4%). 77.7% of the patients were on combination therapy, whereas 22.3% of them were on monotherapy. The most common combination was MS+SGAP (41.4%) and quetiapine was the most commonly used SGAP (41.4%). Tremor, increase in apetite, hypersomnia, forgetfulness, extrapyramidal side effects, gastrointestinal complaints, defatigation, weight gain and headache were the most commonly declared side effects. 8.1% of the patients were fully compliant, 54.5% were compliant, 31.3% were partially compliant and 6% were noncompliant to the treatment. Conclusions: This is the first study in Turkey which evaluated pharmacological treatment options in elderly patients with BD. This study emphasized that combination treatments were commonly preferred, lithium usage was as common as valproic acid, SGAP drugs were frequently preferred and the most common one was quetiapine. 62.6% of the patients had good compliance to the treatment. These results were consistent with previous studies on elderly and young BD patients. Prospective studies about the treatment of BD in the elderly and treatment guidelines in accordance with them are needed. agents (36.4%) and

Keywords

• antipsychotics, bipolar disorder, geriatric psychiatry, psychopharmacology

Bir üniversite kliniğinde bipolar bozukluk tanısı ile izlenen yaşlı hastalarda farmakolojik tedavi seçimlerinin incelenmesi

Öz

Amaç: Bu çalışmanın amacı bipolar bozukluğu (BB) olan yaşlı hastalarda tercih edilen psikofarmakolojik tedavileri, görülen başlıca yan etkileri ve ilaç uyumunu ilişkin yazın ışığında ortaya koymaktır.Yöntem: Çalışmanın örneklemini bir üniversite hastanesi psikiyatri kliniğine 2006-2011 yılları arasında başvuran BB Tip 1 tanısı almış, 65 yaş ve üzerinde olan 99 yaşlı hasta oluşturmuştur. Hastaların dosyaları incelenmiş ve her hastanın son kontrolünde kullanmakta olduğu ilaçlar, yan etkiler ve ilaç uyumu değerlendirilmiştir.Bulgular: Hastaların %74.4’ü duygudurum düzenleyici (DDD), %71.7’si ikinci kuşak antipsikotik (İKAP), %36.4’ü hipnotik-sedatif ilaç, %27.2’si ise antidepresan kullanmaktadır. DDD olarak en sık lityum (%37.4) ve valproik asit (%36.4) tercih edilmiştir. Hastaların %77.7’sinde kombinasyon tedavisi, %22.3’ünde monoterapi tercih edilmiştir. En sık (%41.4) DDD+İKAP kombinasyonu, İKAP olarak da hem kombine hem de monoterapide en sık ketiyapin (%41.4) kullanılmaktadır. Bildirilen başlıca yan etkiler tremor, iştah artışı, hipersomni, unutkanlık, ekstrapiramidal yan etkiler, gastrointestinal sistem yakınmaları, halsizlik, kilo artışı, baş ağrısıdır. İlaç

Anahtar Kelimeler

• antipsikotikler, bipolar bozukluk, geriyatrik psikiyatri, psikofarmakoloji

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