Anticonvulsant Use in Older Age Bipolar Disorder in a Global Sample from the Global Aging and Geriatric Experiments in Bipolar Disorder Project

Abstract

Background: Anticonvulsants are an essential treatment for bipolar disorder; however, there is relatively little known about their use in older age bipolar disorder (OABD). In this paper, which leverages a large international dataset, we aim to 1) describe the use of anticonvulsants in OABD compared to younger age bipolar disorder (YABD; ages <50 years old) and 2) explore any demographic/clinical correlates.Methods: A secondary analysis was conducted on the international data from the Global Aging and Geriatric Experiments in Bipolar Disorder project. The main objective was to report the prevalence of anticonvulsant use in OABD over 50 years old (mean age = 62.27) and the most prescribed anticonvulsant. Additional analysis explored any demographic and clinical correlates associated with anticonvulsant use. Generalized linear mixed models were used for this analysis.Results: Of the 2,691 participants with bipolar disorder who had anticonvulsant prescribing data, 34.4% (n = 926) used anticonvulsants at the time of study. Rates of anticonvulsant prescribing did not significantly differ between OABD and YABD groups (36.7% (n = 666) vs. 29.7% (n = 260)). Anticonvulsant prescribing patterns for OABD and YABD did not significantly differ, with valproate as the most prescribed anticonvulsant. OABD anticonvulsant users had less lithium use, more antidepressant use, more rapid cycling, more mood episodes and more cardiovascular comorbidities compared to nonusers.Conclusion: Anticonvulsant use was similar in OABD and YABD. A number of important clinical correlates of anticonvulsant use were identified.