Faculty, Staff and Student Publications

Language

English

Publication Date

2-15-2026

Journal

Journal of Affective Disorders

DOI

10.1016/j.jad.2025.120704

PMID

41276138

Abstract

Background: Antidepressants are still commonly prescribed in bipolar disorders, despite ongoing controversy of the potential risk of inducing hypomania/mania. There is limited knowledge about the characteristics of antidepressant use in older age bipolar disorder (OABD; age ≥50) in the current literature.

Aim: To describe antidepressant use, sociodemographic and clinical correlates of a global sample of OABD individuals.

Methods: The Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) consortium provided cross-sectional international data on OABD individuals (n = 746) and younger-age bipolar disorder (YABD, age < 50 years; n = 692) regarding antidepressant use. Multivariate logistic regression was employed to assess the association between AD use with demographic and clinical variables.

Results: Of 1252 participants, 33.1 % of OABD individuals and 38.1 % of YABD individuals were using antidepressants. In multivariable models among OABD, antidepressant use was associated with BD type II (OR = 1.61, 95 % CI: 1.09-2.38), higher depression severity (mild-to-moderate: OR = 1.86, 95 % CI: 1.13-3.06; severe: OR = 4.23, 95 % CI: 2.38-7.50), lower YMRS scores (OR = 0.93, 95 % CI: 0.89-0.97), female sex (OR = 1.37, 95 % CI: 1.00-1.89), lower education (OR = 0.61, 95 % CI: 0.43-0.86), and being unemployed (OR = 0.69, 95 % CI: 0.50-0.96). Antidepressant monotherapy was reported in 18 % of OABD users (n = 46) and 19 % of YABD users (n = 51). These findings suggest that both clinical severity and sociodemographic characteristics influence antidepressant prescribing in OABD.

Conclusion: Antidepressant use was less prevalent in OABD compared to YABD, and associated with female sex, lower education, lack of occupation, type II BD, higher depression severity and lower mania scores. In OABD, antidepressants appear to be used more commonly in contexts where they may be clinically more indicated, such as increased depression severity.

Keywords

Humans, Bipolar Disorder, Antidepressive Agents, Female, Male, Middle Aged, Cross-Sectional Studies, Aged, Adult, Age Factors, Severity of Illness Index, Antidepressants, Bipolar depression, Bipolar disorder, Depression, Elderly, Geriatrics, Older age bipolar disorder (OABD), Psychiatry

Published Open-Access

yes

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.