Should we increase the dosage of mom's Zoloft to help with her symptoms of dementia?

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My 94 year old mother has dementia. She is getting to a stage where she is becoming suspicious, angry, agitated and also has hallucinations which have been going on for the last two years. She is currently on 25 mg of zoloft and her dr seems to think that increasing the dose to 50 mg might be of help. She dreams of her deceased relatives and thinks they have visited her during the night. I would appreciate any comments as to whether increasing the dosage would help. Also, would anyone know how to protect the assets from a life insurance policy which has a cash-in value from Medicaid. This policy is solely for her burial costs, but I was told since it can be cashed in, it is considered an asset and would keep her from getting medicaid, should she have to go to a nursing home. She lives with me and my husband and has no other assets. Would appreciate any comments on this as well. Thank you.

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On the insurance policy ... You can prepay funeral expenses as part of the Spend Down (or at any time). So if you cash the policy and buy a prepaid funeral services you'll accomplish the objective without interfering with qualifications for Medicaid. (That is true in this state -- I suppose other states could have different rules.)

If her doctor thinks more zoloft might help, I say try more zoloft. Are the hallucinations/delusions distressing to her?
My mother's dementia is very much like that of your mother's. I would really like to know why increasing her zoloft would help her . Please let me know what you decide as I am really thinking of putting my Mom in Alz/dementia assisted living. Just don't know if I can continue this at the expense of my family life. I am really torn. Thanks for any info you might have. Carol
I don't know if Zoloft helps with memory, did the Dr. suggest that it does? I took Zoloft for about 6 months a few years back and even though it helped with depression I think it actually triggered Restless Leg in me and even though I quit the medication I haven't gotten completely rid of the RL. My mom's Dr. told us that many depression medications may actually cause more memory problems .
She is on one right now called Celexa.
tigerl -- it soesn't sound to me like the dr thinks more zoloft is going to improve her memory, but rather that it might help with other behaviors, like hallucinations, paranoia, etc.

I wonder what kind of dementia gkerg's mother has. That might make some difference in what drugs are typically most effective. But even then, Your Mileage May Vary. I say if the dr thinks more zoloft may help, why not try it?
JeanneG my ? too.

Gkerg, what type of hallucinations? JG & I both have experience with family that has Lewy Body Dementia. Certain types of hallucinations are a hallmark of this type of dementia. The LBD drugs are kinds different from the Alz. ones. I'd do the up in Zoloft especially if you have confidence in how mom's care has been so far.
My mom is on Remeron for anxiety & Exelon for LBD. For her, getting them consistently at the same time is very important.

At 94 you don't have any breathing room for the Medicaid look back. As others have said if it has a cash-value, Medicaid will require it be cashed in and used to pay for her care. Do it now so you can do the "spend down" the way you need to rather than have to give it all to the NH.

“Spend down” – means get assets (excluding homestead & car) under the state’s Medicaid asset ceiling. They can buy funeral and burial policy, a small term life insurance (like 1K or so to take care of final expenses). These must be irrevocable with no cash value. Glasses, dental care (spotty on Medicaid), hearing aids, walkers. You could go to Target,etc.and buy all new clothes for her,
Just keep all the receipts - you may have to show that really you did buy her 3 pair of SAS* shoes and it cost $ 248.00. No $ gifted to others. Everything must be for their care or their property. You could buy her an inexpensive car - although this might red flag the application but they CAN own a car. The Medicaid look back is 5 years. The state can go thru 5 years of all bank records & also require to see receipts to any item that pique’s their interest. Medicaid is different for each state so go to your state's site to see the specifics.

The Medicaid application is cumbersome but not difficult if you are organized and haven't commingled any of their money and they don't own anything.Good luck.

* I swear ever gal in my mom's old IL had at least 5 pairs of these shoes.
My Father was just fine at 96 a month ago.He had urinary tract infection.He went from assisted living where he was able to eat well and drive his own car to a nursing home where they put him on Zoloft.He is unable to eat well sleep well and is depressed.He don't even want to go to his doctor appointment at VA.He told me today he feels like giving up,tears came in his eyes.He was fine not long ago and his urinary tract infection is gone.Zoloft is sure not working.I think it is making him depressed.It sure isn't helping.
goldenzz, no drug works consistently for every person. Zoloft may be swell for many persons in your father's situation, but obviously it isn't swell for him. Even though he does not want to go to his doctor appointment I hope you can get him there, and then discuss the medication issues. If for some reason you can't go to the appointment or it is not very soon, discuss your concerns with the doctor by phone or email.

Putting him on Zoloft may or may not have been appropriate, (often the only way to tell is to try) but keeping him on it at the present dose does not sound appropriate.



Could Zoloft worsen or increase the hearing of sirens and emergency vehicles for someone with dementia? Our 90 year old mother started taking 25 mg, and her symptoms seem to have gotten worse very quickly.
NO to more Zoloft, because it is an SSRI that can trigger manic behavior when you give the patient too much of it. Nor will it increase memory, nor will it stop hallucinations, nor will it treat anxiety. Instead, treat the anxiety with Xanax or Ativan or Klonopin. Hallucinations need totally different drugs than taking antidepressants. Make sure the MD knows ALL the symptoms, because more is not necessarily better.
Report the worsening symptoms to the doctor. There are lots of alternative meds of this type to try.

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