Bipolar Disorder :: Study to compare efficacy of mood stabilizers for geriatric patients of bipolar disorder

Until now, there has been little research on the best ways to care for geriatric patients with bipolar disorder. Now, a major National Institute of Mental Health (NIMH)–funded multi-site clinical research study — led by the Weill Cornell Institute of Geriatric Psychiatry at NewYork-Presbyterian Hospital/Westchester Division — is the first to compare the efficacy of two commonly used mood stabilizers for geriatric patients suffering from the episodes of symptoms that characterize bipolar disorder, formerly known as manic-depressive illness.

Participating in the ongoing study are patients aged 60 and older whose bipolar disorder has been treated with carefully monitored dosages of either lithium or valproate. To date, more than 80 patients at six study sites, including 19 at NewYork-Presbyterian/Westchester, have participated. To address some of the barriers faced by the elderly in need of treatment, the Weill Cornell Institute of Geriatric Psychiatry is reaching out to the community. There is no cost for participating and, if needed, free transportation to the campus may be provided.

Known as Geri-BD (Geriatric Bipolar Disorder), the NIMH study is being led by Dr. Robert C. Young, a professor of psychiatry at Weill Cornell Medical College with more than 30 years of clinical and research experience, and his colleagues at the Institute. Dr. Young’s focus has been the development of information to improve the pharmacological management of elders suffering severe mood disorders.

Dr. Young notes that the Geri-BD study is intended to fill a gap, noting that “evidence-based guidelines for older bipolar patients are critically needed, given the increase in the over-60 age group.” About 10 million Americans — or approximately 3.3 percent of the total population — have been diagnosed with bipolar disorder. The American Psychiatric Association estimates that the number of elderly patients with bipolar disorder will grow significantly over the next few decades.

Dr. Young adds: “To date, most bipolar disorder treatment studies have been conducted in younger patients. However, in some aged bipolar patients, a good symptom response is difficult to achieve, and the mortality rate in elder bipolar patients is relatively high. We hope that findings from this study will help physicians better manage the care of their geriatric bipolar patients.”

Bipolar disorder involves periods of elevated mood — mania or hypomania — and periods of depression or “mixed” episodes in which patients have both kinds of symptoms. Examples of manic symptoms are high levels of energy, going without sleep for extended periods, elated mood or irritability, and impulsive or reckless behavior. Patients may not recognize that they are having symptoms. “Another problem is that although there can be extended periods of normal mood, particularly with treatment, most people with bipolar disorder suffer from recurring symptom episodes,” says Dr. Young.

Over the course of this nine-week study, Geri-BD participants are closely monitored by a psychiatrist who checks their mood state at each visit, assesses any side effects and measures the level of medication in their blood. “We’re finding that studying older adults with bipolar disorder under standardized treatment is feasible and can be well tolerated,” Dr. Young explains.

Individuals over 60 wishing to participate in the bipolar disorder research study at the Weill Cornell Institute of Geriatric Psychiatry located on the NewYork-Presbyterian Hospital White Plains campus are advised to call (914) 997-4331 or (800) NYP-1902 for a free, confidential bipolar screening. Candidates may qualify if they have experienced an increase in energy or a reduced need for sleep, or have been extremely irritable or feeling “on top of the world,” or have been previously diagnosed with manic depression or bipolar disorder.

NewYork-Presbyterian/Westchester and five other research sites throughout the U.S. have been participating in the investigation since 2005: University of Pennsylvania, University of Pittsburgh, Case Western Reserve University, Duke University and Baylor College of Medicine.

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