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A first manic episode in an elderly patient

Published online by Cambridge University Press:  13 August 2021

E. Rodríguez Vázquez ,
C. Capella Meseguer ,
G. Guerra Valera ,
A. Gonzaga Ramírez ,
M. Queipo De Llano De La Viuda ,
I. Santos Carrasco  and
J. Gonçalves Cerejeira
E. Rodríguez Vázquez*
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
C. Capella Meseguer
Affiliation:
Psiquiatría, HCUV, Valladolid, Spain
G. Guerra Valera
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
A. Gonzaga Ramírez
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
M. Queipo De Llano De La Viuda
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
I. Santos Carrasco
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
J. Gonçalves Cerejeira
Affiliation:
Psiquiatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
*
*Corresponding author.

Abstract

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Introduction

The bipolar disorder is characterized by instability mood. It normally happens in the middle-aged. In elderly patients with a first manic episode, you have to dismiss organic pathology.

Objectives

To present an elderly patient with a first manic episode

Methods

A descriptive study of a clinical case and literature review

Results

A 67-year-old man, married. Consulted Mental Health 5 years ago, about low mood after his early retirement. With no psychiatric treatment. Somatic antecedents: Acute myocardial infarction, hypertension and dyslipidemia. Came to the hospital accompanied by his son-in-law presenting rapid speech and thinking, bright clothing, risky behaviour, irritability, grandiosity deliration ideas and less sleep; being necessary a hospital admission. Blood and urine analysis: with no abnormalities. No toxics in the urine. Asenapine 20mg and Lorazepam 3mg were prescribed with clinical improvement. Brain CT: with no abnormalities. After that, Lithium 400mg per day was prescribed to avoid the induction of depression. Clinical judgement: manic episode. Bipolar disorder Type I

Conclusions

After dismissing somatic causes, the symptomatic treatment of a manic episode in older patients is on the same lines as the treatment for mania in young adults. 8-10% of psychiatric inpatients over age 55-60 years are diagnosed with bipolar disorder. Since there is an increase in the number of individuals living longer, an expected increase in the number of older adults who will be diagnosed with bipolar disorder. Older adults with bipolar disorder will increase in absolute numbers as well as the proportion of the general populations.

Disclosure

No significant relationships.

Keywords

bipolar disorderelder patientfirst episodemanic
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S618 - S619
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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