Michael E. DeBakey VA Medical Center - Houston, Texas

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VA Physicians Exploring Effectiveness of Bipolar Disorder Medications on Older Adults

September 25, 2008

HOUSTON - The Michael E. DeBakey VA Medical Center (MEDVAMC) is currently conducting two clinical research studies for patients over the age of 60 with bipolar disorder.

Bipolar disorder affects one to three percent of the general population. Physicians are seeing greater numbers of elderly patients with this illness due to the increasing geriatric population in the U.S.; however, information to guide dosing and effectiveness of bipolar medications in the elderly population is very limited.

Bipolar disorder, also known as manic-depressive illness, is a brain disorder causing unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. The periods of highs and lows are called episodes of mania and depression.

Signs and symptoms of mania include unrealistic beliefs in one's abilities and powers; poor judgment; abuse of drugs, particularly cocaine, alcohol, and sleeping medications; and provocative, intrusive, or aggressive behavior. A depressive episode may be characterized by feelings of hopelessness or pessimism; difficulty concentrating, remembering, or making decisions; restlessness or irritability; chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury; and thoughts of death or suicide.

"Bipolar disorder can result in damaged relationships, poor job performance, and even suicide. But there is good news. Bipolar disorder can be treated, and people with this illness can lead full and productive lives," said Rayan Al Jurdi, M.D., MEDVAMC psychiatrist.

The current research studies focus on individuals, both veterans and non-veterans, over the age of 60 who are currently experiencing bipolar or manic-depressive symptoms and who meet study eligibility criteria.

The first study is for individuals over the age of 60 with bipolar disorder who are experiencing primarily manic symptoms. Two existing mood stabilizers, lithium and divalproex, are being studied for effectiveness and optimal dosing in elderly populations. Both medications are FDA-approved for use in manic patients.

The second study is focused on bipolar patients over the age of 60 who have mostly depressive symptoms. Lamotrigine, an anticonvulsant commonly used for the treatment of bipolar disorder, is being studied for effectiveness in elderly populations and is also FDA-approved for this use.

"With aging, many people with bipolar disorder continue to experience mood swings and a significant number develop symptoms for the first time. Although effective treatments exist, many times these problems may remain undiagnosed, untreated, or undertreated in the elderly population. With this study, our goal is to provide guidelines for safe management and adequate treatment of this illness among elderly patients," said Mark E. Kunik, M.D., M.P.H., MEDVAMC psychiatrist.

VA researchers are also providing free, confidential screenings for bipolar disorder if a person or a family member believes they are experiencing manic or depressive symptoms.

This research study has been approved by the Baylor College of Medicine Institutional Review Board and the MEDVAMC Research and Development Program. Participants will be compensated for their time and travel. For a free, confidential bipolar screening or more information, call the Baylor College of Medicine Clinical Research Volunteer Line at (713) 798-5507.

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