The Carlat Psychiatry Podcast
Mood Stabilizers in Older Adults
Jan 29, 2024
This podcast discusses the use of mood stabilizers in older adults, focusing on lithium and its benefits in preventing suicide and dementia. It compares the efficacy of lithium and Valproeic acid, explores dosing considerations and potential toxicity. The use of lemotrigene as a mood stabilizer is also discussed, highlighting its effectiveness against depressive symptoms.
17:41
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Quick takeaways
- Lithium is often considered the gold standard mood stabilizer for older adults, as it effectively reduces manic symptoms and has anti-suicidal effects.
- Valproic acid may have slight efficacy disadvantages compared to lithium, but it may be more effective in rapid cycling and mixed states in older adults.
Deep dives
Choosing a Mood Stabilizer in Older Adults
Choosing an appropriate mood stabilizer for older adults is crucial in managing bipolar disorder. Lithium is often considered the gold standard, as it effectively reduces manic symptoms and has anti-suicidal effects. Geropsychiatrists worldwide endorse lithium for older adults. A 2017 study revealed that lithium outperformed Valproeic acid in reducing manic symptoms in older adults. Additionally, low-dose lithium may even help prevent dementia. However, dosing must be adjusted in older adults to achieve optimal serum levels and prevent toxicity.
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