2014 AAGP Annual Meeting

study or were in active treatment. Most individuals had substantial baseline depression symptoms (mean baseline MADRS19.45, SD 12.1), moderate/mild general psychopathology (mean baseline BPRS 33.64, SD 9.4) and minimal manic symptoms,mean YMRS 7.27 (SD 4.80). Mean dose of asenapine was 6.4 (SD 5.7) mg/day. The most common adverse effects weregastrointestinal discomfort (n ¼ 3), restlessness (n ¼ 2), and tremors (n ¼ 2), while less common side effects included sedation,headache, and increased appetite. One individual had elevated liver function tests possibly related to study drug which resolvedwith drug discontinuation. Three individuals had more severe adverse effects which caused them to be discontinued from study(manic symptoms (n¼1), recurrence of suicidal ideation in the context of tooth abcess (n ¼ 1), and reported dizzyness/refusalto take additional mood stablizer after taking a single dose of asenapine in an individual with euphoric mania (n ¼ 1)). Onlyone of these more severe adverse effects (manic emergence) appeared to be a possible medication effect. Assessment of availableBD symptoms, disability and extrapyramidal scores noted similar baseline and interim mean scores with variable responseacross individuals and expected complete data collection by first quarter 2014.Conclusions: This sample of geriatric BD patients with a history of sub-optimal response to previously prescribed BDmedication treatments had predominantly BD depressive symptoms. Low-dose asenapine was tolerated by approximately two-thirds of older BD patients with a history of previous non-response while adverse effects prompted drug discontinuation in justover one-quarter of patients. While risks vs. benefits in older people must always be carefully considered, asenapine may be atreatment consideration for some non-demented geriatric BD patients who have poor response to previous treatments.

This research was funded by: This study was supported by an investigator-initiated grant from Merck.

Poster Number: NR 49Antidepressants and driving in the elderly: a systematic reviewMark J. Rapoport, MD, FRCPC; Duncan H. Cameron, BA

University of Toronto, Sunnybrook, Toronto, ON, Canada

Introduction: The potential effects of psychoactive drugs on motor vehicle operation have been investigated perfunctorily inrecent literature, but many studies focus on a young or middle-aged population. Many seniors are diagnosed with depressivedisorders, for which antidepressant drugs are commonly prescribed medications. The increasing number of senior driversmakes the possible consequences of antidepressant use on driving skills in a senior population a pressing issue.Methods: A systematic review was conducted using MEDLINE, targeting articles specifically pertaining to antidepressants anddriving. Relevant articles were dichotomized into epidemiological or experimental categories. These were subsequently filteredfor articles focusing on an elderly population or subgroup (�55 years of age).Results: An initial search yielded 233 references, 36 ofwhich attended to the effects of antidepressants ondriving.Of these 36 one wasexperimental and six were epidemiological studies which assessed a senior population. The experimental study focused on imipra-mine andnefazodone, concluding that imipraminewas detrimental to standarddeviation of lateral position for highway driving. Theepidemiological studies assessed a wide range of antidepressant drugs - often in addition to other psychoactive medications - andgenerally indicate that most of the antidepressants investigated have significant negative effects on driving performance.Conclusions: Results of this review highlighted a dearth of knowledge concerning the effects of antidepressants on drivingperformance in the elderly. Few conclusive statements are made in the existing literature, and there is a growing need forfurther research in this area.

Poster Number: NR 50Predictors of Binge Drinking in Elderly AmericansRoopali Parikh, MD; Yusef Canaan, MD; Juan D. Oms, MD

Larkin Community Hospital, Miami, FL

Introduction: The increasing trend in elderly binge drinking in the U.S. is cause for alarm. Alcohol consumption in seniors canbe associated with cognitive decline and worsening of comorbidities, including hypertension, stroke, and osteoporosis. Wesought to describe the demographic and clinical characteristics of elderly Americans reporting binge drinking and determinethe independent predictors of binge drinking in this population.Methods: The 2008 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey was utilized to identify a cohortof 4,815 individuals in the U.S. of age 65 or older. Demographic data and clinical history were recorded in these patients. The

Am J Geriatr Psychiatry 22:3, Supplement 1 S145