Demographic and Clinical Characteristics of Antipsychotic Drug-Treated Older Adults with Bipolar Disorder from the Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD).

Psychopharmacol Bull

Chen MD, MPH, PhD, Department of Psychiatry, Geriatric Psychiatry Division, Geriatric Research, Education and Clinical Center (GRECC), Case Western Reserve University School of Medicine, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA. Eyler, PhD, Department of Psychiatry, University of California San Diego, San Diego, CA, USA and Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA. Gildengers, MD, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. Beunders, MD, MSc, GGZ inGeest, Amsterdam, the Netherlands and Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands and Amsterdam Public Health research institute, Amsterdam, the Netherlands. Blumberg, MD, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA. Briggs, PhD, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. Dols, MD, PhD, GGZ inGeest, Amsterdam, the Netherlands and Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands and Amsterdam Public Health research institute, Amsterdam, the Netherlands and Amsterdam Neuroscience, Amsterdam, the Netherlands. Rej, MD, MSc, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Canada. Forlenza, MD, PhD, Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. Jimenez, PhD, Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. Mulsant, MD, PhD, Department of Psychiatry, University of Toronto, Center for Addiction & Mental Health, Toronto, Canada. Schouws, MD, GGZ inGeest, Amsterdam, the Netherlands and Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands. Orhan, MD, GGZ inGeest, Amsterdam, the Netherlands and Amsterdam UMC, location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands and Amsterdam Public Health research institute, Amsterdam, the Netherlands. Sarna, MS, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. Sutherland, MA, Department of Psychiatry, University of California San Diego, San Diego, CA, USA and Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA. Vieta, MD, PhD, Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. Tsai, MD, Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Yala, MPH, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. Villa, PhD, Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA. Sajatovic, MD, Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.

Published: May 2022

Objectives: Antipsychotic drugs (APS) are widely used to treat patients with bipolar disorder (BD), but there is limited information in older-age bipolar disorder (OABD). This analysis of the Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) investigated characteristics of OABD patients prescribed APS vs. those not prescribed APS.

Experimental Design: The observational analysis used baseline, cross-sectional data from 16 international studies for adults aged ≥ 50 years with BD comprising 1,007 individuals with mean age 63.2 years (SD = 9.0), 57.4% women, and mean age of onset 31.6 years (SD = 15.0). The dependent variable was current APS treatment status. The independent variables included demographic and clinical variables, and a random effect for study, that were included in generalized mixed models.

Principal Observations: 46.6% of individuals (n = 469) were using APS. The multivariate model results suggest that those treated with APS were younger (p = 0.01), less likely to be employed (p < 0.001), had more psychiatric hospitalizations (p = 0.009) and were less likely to be on lithium (p < 0.001). Of individuals on APS, only 6.6% of those (n = 27) were on first-generation antipsychotics (FGAs) and experienced a greater burden of psychiatric hospitalizations (p = 0.012).

Conclusions: APS are widely prescribed in OABD, observed in nearly half of this sample with great variation across sites. Individuals with OABD on APS have more severe illness, more frequent hospitalizations and are more often unemployed vs. those not on APS. Future studies need to examine longitudinal outcomes in OABD prescribed APS to characterize underlying causal relationships.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172555PMC

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