title: The geriatric mania asenapine study (GeMS).
abstract: BACKGROUND
  Population aging results in growing numbers of psychiatric disorders among older patients. Yet, there is a paucity of studies on elderly mania.
  
  
  OBJECTIVE
  To evaluate the effect of asenapine on older manic inpatients.
  
  
  METHODS
  Thirty-four elderly patients suffering from a manic episode, mean age 67.2 years were enrolled in an open-label 3-weeks study of asenapine treatment.
  
  
  METHODS
  (1) DSM-IV criteria for manic episode (2) age above 60 years, (3) episode severity necessitating inpatient treatment, (4) Young Mania Rating Scale (YMRS) score at baseline >20, and (5) no prior asenapine treatment. Participants were prescribed asenapine 5 mg BID for 3 days and then dose increased to 10 mg BID till day 21 (study completion).
  
  
  RESULTS
  Twenty-five patients completed the study. YMRS score decreased from a baseline mean of 27.0±8.8 to 13.3±12.0 at the end of the study (p<0.001). Fourteen patients (56% of completers) achieved remission (YMRS score<12). MADRS score decreased from a baseline mean of 7.6±5.6 to 4.4+5.1 at the end of the study (p<0.05); low baseline score should be noted. Sleep duration increased from a baseline median of 5.7 hours to 7.0 h at the end of the study (p<0.05). Seven patients discontinued treatment due to adverse events. Two patients passed-away after study completion.
  
  
  CONCLUSIONS
  We tentatively conclude that the efficacy of asenapine in reducing acute manic symptoms and achieving remission in the elderly is supported in this study. Caution is needed in patients with co-morbid physical conditions.
authors.affiliation: Abarbanel Mental Health Center, Affiliated with the Sackler School of Medicine, Tel-Aviv University, Bat-Yam, Israel. Electronic address: mdybarak@gmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Barak
authors.affiliation: Kfar-Shaul Mental Health Center, Jerusalem, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Finkelstein
authors.affiliation: Abarbanel Mental Health Center, Affiliated with the Sackler School of Medicine, Tel-Aviv University, Bat-Yam, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Pridan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003986:Dibenzocycloheptenes; D005260:Female; D006576:Heterocyclic Compounds, 4 or More Rings / Q000009:adverse effects / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D003986:Dibenzocycloheptenes; D006576:Heterocyclic Compounds, 4 or More Rings; C522667:asenapine
keywords: Asenapine; Elderly; Mania