Activity Preview


Highs and Lows: Clinical Pearls and Lessons Learned in the Outpatient Management of Geriatric Bipolar Disorder

Activity Type:

  • On Demand

Release Date: 3/1/2020

Expiration Date: 3/1/2023

  • AMA PRA Category 1: 0.75
  • Participation: 0.75



In this course, knowledge regarding literature updates, as well as guidelines for treatment of the aging patient with bipolar disorder are shared. This course highlights several challenging and complicated cases of geriatric bipolar disorder treated in an interdisciplinary outpatient clinic, sharing lessons learned from those clinical encounters with the assistance of a clinical psychiatric pharmacist. The management of traditional mood stabilizers and associated symptoms of subtle toxicity related in the context of medical co-morbidity and aging is also reviewed, along with the difficulties of managing a patient with newly diagnosed Parkinson's disease. Lastly, a case will be presented on neurocognitive decline concerning for a major neurocognitive disorder in a patient with longstanding bipolar disorder. 

**This content was captured at the 2019 APA Annual Meeting and may reference information from various sources and terminology from previous editions of the DSM.


FREE- $0

Funding for this initiative was made possible (in part) by Grant No. 1H79SM080818-01 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. (Effective April 15, 2020)

Course References

  • Abdul-Hamid WK et al. Comparison of how old age psychiatry and general adult psychiatry services meet the needs of elderly people with functional mental illness: cross-sectional survey. Br J Psychiatry. 2015;207:440-3.
  • Sajatovic M, et al. International Society for Bipolar Disorders task force for older adults with bipolar disorder: A report on older-age bipolar disorder from the International Society for Bipolar Disorders Task Force. Bipolar Disord. 2015 Nov;17(7):689-704.
  • Forester BP, Ajilore O, Spino C, Lehmann SW. Clinical characteristics of patients with late life bipolar disorder in the community: Data from the NNDC registry. Am J Geriatr Psychiatry. 2015 Sep;23(9):977-84.
  • Young R, et al. GERI-BD: A randomized double-blind controlled trial of lithium and divalproex in the treatment of mania in older patients with bipolar disorder. AJP in Advance. 2017 Aug 4:1-8.

Learning Objectives

  • Evaluate the pharmacologic management strategies of bipolar disorder in patients with co-morbid Parkinson's disease
  • Discuss the complications of bipolar symptoms associated with the pharmacologic agents used to treat Parkinson's disease
  • Review the use of mood stabilizers in a geriatric patient with bipolar disorder and an emerging major neurocognitive disorder
  • Explore and discuss cases of subtle toxicity from mood stabilizers in the geriatric population

Target Audience

Psychiatrists, Residents/Fellows

Estimated Time to Complete

Estimated Duration: 45 minutes
Begin Date: March 1, 2020
End Date: March 1, 2023

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned. 

Continuing Education Credit

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

The APA designates this enduring CME activity for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

Program Presenters

  • Erica C. Garcia-Pittman, MD, FAPA, Associate Professor, Dell Medical School Department of Psychiatry. Reports no financial relationships with commercial interests.
  • Tawny L. Smith, PharmD, BCPP, Psychiatric Pharmacist, Assistant Professor of Psychiatry, Dell Medical School. Reports no financial relationships with commerical interests.
  • Anh-Thu Tran, MD, Public Psychiatry, Austin Travis County Integral Care. Reports no financial relationships with commercial interests.
  • Victor M. Gonzalez, Jr., MD, Fellowship, Geriatric Psychiatry, University of Texas Health Science Center at San Antonio. Disclosures: Other - Boehringer Ingelheim Pharmaceuticals, Inc. (serving as sub-investigator for two phase II trials)
  • Alexandra Harrison, MD, Locum tenens, Austin, TX. Reports no financial relationships with commercial interests.

Program Planners

  • Tristan Gorrindo, M.D., Director of Education, American Psychiatric Association. Reports no financial relationships with commercial interests.
  • Katie Putnam, Membership Development Specialist, American Psychiatric Association. Reports no financial relationships with commercial interests.
  • Ally Brown, Senior Program Manager, Online Learning, American Psychiatric Association. Reports no financial relationships with commercial interests.

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Hardware/Software Requirements

This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

  • Flash Player: Adobe Flash Player 10.3+ 
  • Browser: Firefox (latest version), Internet Explorer 8.0+, Safari 7.0+, Microsoft Edge (latest version) or Google Chrome (latest version)
  • Operating System: Windows XP+ or Mac OS X 10.4+ 
  • Internet Connection: 1 Mbps or higher

Minimum Requirements:

  • Windows PC: 500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Macromedia Flash Player 10.3 or higher; Sound Card at least 16-bit; audio playback with speakers for programs with video content
  • Macintosh:Mac OS X 10.4+ or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit; audio playback with speakers for programs with video content

Need Assistance? contact for questions about this course | contact for technical assistance

All materials copyright American Psychiatric Association ©2020.