Tratamento do transtorno bipolar no idoso: uma revisão da literatura
DOI:
https://doi.org/10.25118/2236-918X-7-6-3Palabras clave:
Bipolar, idoso, tratamento, mania, depressão, envelhecimentoResumen
O transtorno afetivo bipolar (TAB) é uma condição potencialmente grave, caracterizada por mudanças de humor e disfunção cognitiva e funcional. O presente artigo revisa as evidências atualizadas das intervenções farmacológicas e não medicamentosas direcionadas ao TAB em idosos. Diretrizes baseadas em evidências, embora sejam úteis na promoção de uma terapia racional e eficaz, ainda são relativamente reduzidas no TAB em idosos. As recomendações atuais para mania aguda incluem o uso de antipsicóticos atípicos (por exemplo, risperidona, quetiapina, olanzapina), lítio (de maneira criteriosa) e a eleição de valproato como terapia padrão ouro. Na depressão aguda do TAB, os agentes de primeira linha em monoterapia podem incluir lítio, lamotrigina, quetiapina e quetiapina de liberação prolongada. No que se refere à escolha do estabilizador de humor ideal, o maior potencial de efeitos colaterais relacionados ao lítio vem desestimulando sua prescrição em indivíduos idosos. A eletroconvulsoterapia, embora limitada pela evidência, pode ser uma opção para casos graves/refratários.
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