title: Asenapine for elderly bipolar manic patients.
abstract: BACKGROUND
  Bipolar disorder (BPD) in the elderly is probably heterogeneous and its etiopathogenesis is complex. The data for the treatment of late-life BPD are limited. Asenapine is approved in the United States for acute treatment of manic or mixed episodes of bipolar I disorder with or without psychotic features.
  
  
  OBJECTIVE
  We report the results of acute treatment with asenapine in elderly patients with BPD.
  
  
  METHODS
  Elderly patients (N=11), mean age: 67.7 ± 6.1 years, consecutively admitted to the psychogeriatric ward due to acute bipolar mania were treated by asenapine 10mg/BID monotherapy for 4 weeks. Safety and tolerability assessments included adverse events (AEs), laboratory values, and anthropometric measures. Response, a secondary assessment, was measured as change in Young Mania Rating Scale (YMRS) total score from baseline to week 4.
  
  
  RESULTS
  One patient developed a rash on day 6 of treatment and one patient developed peripheral edema on day 14 of treatment. Both AEs resolved rapidly following discontinuation of asenapine. Only mild sedation was reported by three patients. In all cases, mean (± SD) change (improvement) in YMRS total score at week 4 was -21.4 ± 12.9 and 7/11 (63.6%) of patients remitted (YMRS≤12).
  
  
  CONCLUSIONS
  In this small open-label study of elderly patients with bipolar mania, acute treatment with asenapine was well tolerated and effective.
authors.affiliation: Tel-Aviv university, Sackler School of Medicine, Abarbanel Mental Health Center, 15 KKL Street, 59100 Bat-Yam, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Baruch
authors.forename: Shelly
authors.initials: S
authors.lastname: Tadger
authors.forename: Igor
authors.initials: I
authors.lastname: Plopski
authors.forename: Yoram
authors.initials: Y
authors.lastname: Barak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001714:Bipolar Disorder / Q000188:drug therapy*; D003986:Dibenzocycloheptenes; D006576:Heterocyclic Compounds, 4 or More Rings / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales
chemical_list: D014150:Antipsychotic Agents; D003986:Dibenzocycloheptenes; D006576:Heterocyclic Compounds, 4 or More Rings; C522667:asenapine