Lithium Dispensed for Adults Aged ≥ 50 Years Between 2012 and 2021: Analyses of a 10% Sample of the Australian Pharmaceutical Benefits Scheme.

• What is the primary question addressed by this study? What proportion of adults aged 50 years or older living in the community are using lithium? • What is the main finding of this study? The proportion of older adults dispensed lithium decreases with age, from 0.4% for those aged 50–59 years to < 0.1% for those aged ≥ 90 years. Most older adults dispensed lithium were dispensed other medications, such as antipsychotics, antidepressants, anxiolytics/hypnotics, and medications to treat diseases of the alimentary, cardiovascular, endocrine and nervous systems. • What is the meaning of the finding? The proportion of older adults dispensed treatment with lithium is lower than the known prevalence of older adults with bipolar disorder, suggesting that lithium is under-utilized in this population. Lithium use seems to be declining in clinical practice. We examined the proportion of adults aged ≥ 50 years dispensed lithium between 2012 and 2021, and investigated the proportion of lithium users dispensed other medications. We used a 10% random sample data of the Australian Pharmaceutical Benefits Scheme from 2012 to 2021, and limited our analyses to adults aged ≥ 50 years. We retrieved data on lithium, other mood stabilisers, antipsychotics, antidepressants, anxiolytics and hypnotics, and medications for the treatment of other health systems. We received 7081939 person-years records (53.2% women). The proportion of participants dispensed lithium decreased with age: 0.4% for those aged 50-59 years to < 0.1% for people aged ≥ 90 years. The dispensing of lithium increased over 10 years for those aged 50-69 and decreased in those older than 80 years. Among people dispensed lithium, nearly 1 in 5 were dispensed another mood stabiliser. Antipsychotics and antidepressants were dispensed to about 60% of participants dispensed lithium, with antidepressants dispensed more frequently to women than men. About 20% of people dispensed lithium were dispensed anxiolytics/hypnotics, more frequently for women than men. Medications to treat diseases of the alimentary, cardiovascular, endocrine and nervous systems were commonly dispensed to those dispensed lithium, as were antibiotics. While the dispensing of lithium increased among young older adults since 2015 when guidelines for the management of mood disorders were published, our findings suggest that lithium may be under-utilised for the management of bipolar disorder in later life. [ABSTRACT FROM AUTHOR]