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Hi,


I've written about my father before, a very stubborn man, but I have kind of a specific question, "how to get him to realize he really has a problem and that meds can help".


My father goes through periods of time where he's mostly OK, but he'll spin himself up in a cocoon of anxiety which is pretty miserable. About 6 months ago I got him to try Zoloft, he did it for a month, the doctor upped the prescription slight, he got headaches and stopped. Thank god we did this though because we were selling off some of my mother's property and we never would have done it without the Zoloft.


Last week he called me in a total state, practically begging me to get him some Zoloft. I made him contact his GP, who gave the go-ahead for it. Three days in he gets the sweats (a very common side-effect), decides he's not going to take it anymore and that's that.


Note: just because there's a 6 month interval doesn't mean this isn't a regular occurrence, it's always there.


I think, maybe, he's going to talk to his GP about it, maybe try something else, I don't know. The plain truth is I'm certain he just doesn't want to take it.


And look, he's got reasons for anxiety, he can't see, he can't hear (hearing aids down (new one's incoming I hope)), Covid, Fox News, he's 90, etc. And he lives alone, won't accept any help with the house in any fashion or any shape.


Maybe this post is more about me, because frankly I'm just plain tired of this BLEEP! Everything is a fight! I don't think that there has been a single thing I've done for him in the last few years that wasn't either a direct fight or a low grade resistance on his part ("we can talk about that later").


The thing about the meds is, he's clearly miserable. When he was on the Zoloft there was a noticeable difference. He even admits it took the worst of it off. I can state that when he came off it the first time, I knew really quickly something had changed.


Sometimes, when he calls me, wrapped up in the anxiety, I want to say, "tough bleep, dude, you made the choice to be miserable." And, of course, the thing about mental health, it's not really all their choice.


Honestly, I'm just frustrated.

I see several mentioned Xanax and Ativan (Lorazepam.) The Lorazepam was used by the MC facility when mom first moved in (she had dementia and was VERY adamantly against moving anywhere!) They used the mildest dose (0.5mg) The facilities often recommend staying away for the first 1-2 weeks, to allow some adjustment to the move, so I was not able to see the effects of this. They did NOT renew the Rx (I managed her meds, so I would have known if they did!)

However, her first UTI after living there for about 1 year resulted in severe sun-downing, something she had never had before. Along with the antibiotic, they gave her the same small dose. It was just enough to take the edge off, but not enough to impact her otherwise (some side effects are drowsiness, being unsteady, etc.) She only had to take these while the UTI was treated, but it clearly took care of the problem. I know for a fact the only "tumbles" she ever had were NOT when she was taking this medication, not even within months of taking it.

These meds (both are similar medications, but what I read is Xanax acts faster, but wears off sooner, say 6 hrs, vs Ativan lasting 8 hrs - these times are likely very dependent on the dosage given) are for treating anxiety, but worked in mom's case (anxiety can be one of the drivers in these sun-downing cases.) I've been there when mom was given the medications and it clearly did what it needed to do.

What I found nice about this medication is it worked the first time, every time and took about 15 min to take effect. She also didn't have to wean off of it when the UTI was fully treated and they didn't need the anti-anxiety anymore.

The lowest dose may or may not be enough, esp given he's a man and likely bigger than mom. But if he starts by taking the lowest dose, it helps at all and he has no side effects, the doc can increase the dosage as needed, checking in with him and monitoring him for issues. For instance, if he seems calmer for a few hours, then ramps up, perhaps an increase in dosage OR taking it more frequently would keep him on more even keel.

I'm not a big fan of medications, but sometimes they are necessary. If you are allowed to discuss with his doc, perhaps he'd be willing to try this? It also might take consult with a specialist who has much more experience with all these types of medications. One size does not fit all, and the PCP may not have enough experience.

I would try working with his doctor(s) one more time and see how things go. Hopefully they can find the right medication that helps your dad without side-effects. If possible, try to work with dad also, asking him to give the medication sufficient time to do the job and work around any minor side effects. Often side effects may resolve on their own, once the body gets used to taking the meds. Also, is it possible he just had some headaches, unrelated to the medication? Would it hurt to take a minor pain relief to alleviate the headache IF the anxiety is relieved? I do see that headache is listed as a possible side effect, but if he's aware of all side effects, he could just blame it on the meds even if it isn't and stop taking it.

It might also be good to review all his medications, preferably with a pharmacist, to ensure there are no adverse reactions or negating actions when taken with any anti-anxiety medication. Pharmacists are much more aware of issues like this than doctors are.

Hoping some doc out there can find relief for your dad, thereby providing YOU some relief as well!

(Aside: do you or anyone else have POA, to be used if/when it is needed? Medical and financial POAs can be prepared ahead of time and activated when certain conditions are met. These are important. They won't help in moving him or bringing in help if he develops cognitive disorders, but are important for other reasons!)
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Reply to disgustedtoo
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Try hydroxazine. It’s a first phase antihistamine like Benadryl . My husband started experienceing anxiety and sleeplessness that was causing me all issues. Everything we tried ie ativan etc made him worse. This saved his life. The only thing that works to ease his anxiety and helps him sleep with no bad side effects. He can’t take benedryl as it causes mental issues. Too much synemet over tie can do the same. Hydroxazine is pretty benign.
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someguyinca: With his choice of (mainly) managing these medications on his own, e.g. stopping, he is not going to get the benefit that the medication will HAVE to offer if only he gives it a chance. He does know that he needed and asked for the medication, but he cannot, nor should not, be removing himself from them. His physician needs to be notified.
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Reply to Llamalover47
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My mother takes ativan every 8 hrs and a seroquel at bedtime - she is still anxious.
I resumes half a 37.5 effexor every morning and that helps. But the real Godsend is Rescue remedy lozenges. Get them on Amazon - I've used them for years, even with my cats. No side effects.
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My elderly mom took a 1/4 of a .125 xanax every 4 hours, it was tiny amount but gave her relief from worry, crying, etc. Some people are afraid of the benzos but they can help. Hang in there!
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Reply to Darsouthwest
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I think the time has come to have a firm, tough caretaker who can handle him and his outbursts and have him do what he has to do. If this does not work, you have two options that I see. First, you let him make his bed and lie in it - his choice. Perhaps he will see the light but I doubt it without causing you great grief in the meantime and I don't think you should allow that or put up with it. Second, he needs to be in a facility. It is obvious to me that someone has to be in "control" of him when he does crazy stuff and it should not be you. Good luck.
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disgustedtoo Feb 14, 2021
You can't force anyone, not even those with dementia to do what YOU want them to do (NO mention of dementia here, just anxiety.) So, facility is out, unless the man wants to move to one. He also refuses to have someone in, so that is out as well.

There's no mention of "crazy stuff" that he is doing.

You can't CONTROL other people, as much as you'd like to and often suggest.

Most of your comments are useless.
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Zoloft isn't like aspirin. Its effects build thru regular use. It also isn't wise to just stop taking it cold turkey. A doctor can advise a ramping off dosage. It also can have obscure side effects that manifest in different ways at different life stages. So maybe what worked like a charm five years ago is now causing dry eye or dry mouth (happened to me) or some other unpleasant side effect. Is your dad specific about the side effects? Is he able/willing to keep a diary of when and what is happening. Might be helpful to engage him in an "investigation" of his issues and drug reactions. Medical marijuana without the ingredient that gets him high might be worth pursuing, especially if you call it by its scientific name. Good luck.
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Reply to Sgcinsd
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He does realize he has a problem. He does know that the meds can help. Otherwise he wouldn't have agreed to take them at any point; and as you say he himself has stated that the Zoloft did take the edge off.

So I don't really see that there's anything left to tell him that he doesn't already know. If anyone is to be more prescriptive about the instructions maybe it should be his doctor: "If you want to feel better, take these. You are likely to experience x, y, z side effects in the short term but those side effects will wear off, so stick with it. Report back to me in six weeks."

Your role is then to be the broken record, repeating "take your meds." Just avoid adding the censorious remarks about his choosing to be miserable! - no matter what your level of frustration, after all it isn't you who suffers if he won't do as he's told, it's him.

We currently have a client who's just had his anxiety medication doubled. Personally I should much have preferred to give him twice as much time and reassurance than twice as much medication; but for one thing we don't *have* twice the time available, for another, the reassurance is not always successful, and most of all I'll be the first to admit that his not being terrified and feeling under attack when it's time to get ready for bed is definitely in his best interests. The meds do work.
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Reply to Countrymouse
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Since your father has an anxiety disorder, he would benefit from seeing a geriatric psychiatrist. Ask his doctor for a referral; make him an appointment if his insurance does not require a referral. Explain that there are many types of medications that can help him; psychiatrists have more training in dealing the these medications and handling side effects. I am sure a psychiatrist can help him find the right therapies (including turning off the tv most of the day) that will alleviate his symptoms. Just be aware it may take a year or 2 to find the right combination that works. Psych meds need to reach a threshold in the blood stream - and this can take time.
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My aunt, almost 92 sounds a lot like your dad. She has had a tough year with the social distancing and recently ended up in the hospital with chest pain, which turned out to be acid reflux. She is also highly anxious, listens to nonstop news, lives alone and refuses to consider moving to assisted living. She saw the neurologist recently and he suggested trying Lexapro, “for anxiety and help with short term memory”. It’s a very low dose to start but she hasn’t had any side effects yet. Telling her it will help with short term memory has been helpful to get her on board with taking something, since she knows she has a problem there and her anxiety affects her ability to focus her attention. I set up her pill boxes two weeks at a time now, put the pill in with everything else and so far, so good. It takes awhile to see any differences but I am hopeful.
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There are alternatives to Zoloft if the Zoloft has side effects, but some of them are more expensive so the insurance companies push people to try other drugs first. Wellbutrin is one “atypical” antidepressant that can work well with fewer side effects, and there are others. Some people take a combination of meds like Wellbutrin plus Buspar, or Olanzapine plus Prozac. Your dad’s doctor should be able to suggest a different medication. And if the doc doesn’t have a lot of experience with geriatric medications for depression/anxiety, it’s worth finding someone who does. The wrong meds can make a person so miserable that they prefer to suffer without them, but the right ones can work miracles,
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Reply to Kentuckienne
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I think I replied to you last time. My dad took Zoloft his last few years. He was hugely opposed to any med for “stuff like that” and the only thing that got him taking it was the wording of the doctor who prescribed it. The doc wisely never said anxiety or depression. My dad was incredibly anxious and worried over everything, I definitely feel your Fox News pain, and I’ll raise you the Weather Channel! Each storm was a new worry. He never complained of side effects from the Zoloft. I’ll attribute that to a pill case loaded with it and being taken at the exact same time daily, no variation. I hope your dad will give it another shot and be steady with it. If not, you’ve done all you can and you join the club of so many here in waiting for an event that will happen to force change.
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Reply to Daughterof1930
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The thing is, some people feel like they can fiddle around with medication like it's Tic Tac, taking it for a few days and deciding to ditch it because they get a headache, forgetting that the slight headache is a whole lot better than the crushing anxiety the medication is alleviating. Then they'll go back on the meds again, to 'give them another try', find another slight side-effect, forget about the benefits and focus on the negatives, and back on the hamster wheel you all go again. The goal is to get dad to commit to taking a COURSE of medication for a few MONTHS, not for a few days. To agree to let the chips fall where they may, to let the side effects occur with the hope that the MAIN issue gets rectified. To keep his eyes on the prize which is general relief from major anxiety and misery.

Part of OCD is feeling the need TO focus on the slight details of every single thing that occurs in life. They can't see the forest through the trees as a result. So your dad cannot see the benefit of the Zoloft b/c he's too busy focusing on the headache he had and needs to find a way to get rid of IT. He can't get off of the hamster wheel until & unless his doctor has him commit to a solid regimen for a decent length of time, period. I don't know if you can get that fact across to him; THAT will be your goal, and maybe something you can convey to his doctor.

I feel your frustration. People with high anxiety & OCD tendencies are extremely difficult to deal with, I know. My mother is 94 and has moderately advanced dementia. I just had a 'conversation' with her where I tried (futilely) to talk her off the ledge she was on b/c she'd gone to dinner with some 'old ladies' who had ramped her up something fierce. Instead of wheeling herself away & going back to her room, she stayed with them and was SO anxiety ridden by the time I had called her that she was talking about wanting to die, and had 'peed herself'. I can't tell you how frustrated this makes ME because we have this talk continuously about how she should just stay AWAY from certain situations, but she just won't. Dementia is at play here, along with chronic and intense anxiety/OCD, so it just makes matters 1000% worse. She's on enough anti-depressants to calm down 10 people, yet it's like she takes a placebo. For some people, there ain't no pill on earth gonna help 'em.

Wishing you (and me) the best of luck dealing with very difficult people.
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Reply to lealonnie1
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Hi,

I wanted to follow up on this.

My father and I talked today and he agreed he should take something. He said he felt better on it but he doesn't like the side-effects. He also talked to a new friend which seemed to help. And, he's going to have another conversation with his doctor.

So, I'm hopeful.

To be honest, and I think sometimes we forget that this affects us, but I've been listening and dealing with some level of his anxiety and depression for 4 years. My capacity for it just isn't there.

And I get breaks from it. I, honestly, don't know how some of you manage who not only deal with this and the other various parts of aging but do so for years on top of years. I have some distance, space and decent financial resources. It's got to be a nightmare for some.

Anyways, thanks for the replies.

Getting old is a hard business.
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notgoodenough Feb 8, 2021
My daughter has been on various dosages of Zoloft for quite a few years now for anxiety/depression. When she comes down in dosage, she has some wicked side effects; she also deals with side effects when she needs to up her dosage, but not as bad.

But really, having gone on this journey with my daughter, it seems to me that in order for the medication to really work, there had to be therapy sought out in conjunction with it.

My daughter had terrible panic attacks. When we finally found a child psychiatrist whose first instinct wasn't to medicate her to the point of numbness ( another long story) he explained her medication regiment as such: you take the medication to keep from having the physical symptoms of a panic attack; once that's under control you can start to address the reasons WHY you're having the panic attacks.

Your dad might need more than "just" the medication.

Gold luck.
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I am going to assume from your name that you live in California? Of course, the CA might be Canada, in which case this advice won't work.
I am shocked at myself for suggesting this, as I worked in Federal Law Enforcement for 34 years. Have you tried medical marijuana? In an edible form? If his PCP is aware of the problem with the Zoloft, he/she might be willing to prescribe marijuana for your dad. Just a thought.
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someguyinca Feb 8, 2021
I thought about this but he'd never go for it.
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My DH takes Zoloft and thinks he doesn't need it (oh, my, yes he does,. and probably a kicker for anxiety too!) He thinks I don't know that he'll often try to go off it on his own...nobody knows he takes it and nobody really 'cares' but to him, AD's are for the weak (women) and he hates that that it really, really helps. Am I making sense??

He went on it b/c I said he HAD to do something to help his anger problems and mood swings. Zoloft works and works well.

We're at the point in our marriage where we're sick of each other and he has been working his incredibly stressful job from home for the past year. EVERYTHING I DO is annoying to him and he'll start in after lunch with small snarky comments and by dinner I am so sick of him I want to scream. He ALSO won't wear his h/a's so he's shouting all day long at the computer and his online co-workers. He'll seek me out and yell 'to' me when things aren't working at work and I can't help him--but I also can't take his anger/frustration.

He's also addicted to FoxNews and has it on the TV all day long. He's only 69, but has gotten worse over the year--he's talking of retiring, but he hasn't made any moves in that direction, so I hope he stays for one more year. We need him to be back in the office and traveling. We need a plan for him to retire, or else he'll never get out of bed again.

I feel your pain--I have not gone the route of grinding up the Zoloft into food (for one thing, it's really nasty) but I have counted pills and called him out when he's super grouchy and made sure he knows he NEEDS to take this med.

Your relationship is different as it's your dad. I would not be so invested in my dad. But my DH, I have to live with.

Until they become AWARE that they NEED these meds to supply the chemical that their brains no longer NEED...they will not take them willingly nor consistently.

I hated being 'the bad guy'. But one thing that saved me was when my SIL had to be on something while he was doing his fellowship in Transplant medicine. He was on an AD for a couple years. I would not normally have shared that with my DH, but b/c he respects my brilliant SIL, he went 'so Joe takes AD's? Really?' and it changed everything.

Good Luck. I am on 2 meds just so I can live with DH w/o having daily meltdowns. Stupid when you have to medicate so you can live with the one person you should want to be with the most. But it is what it is.
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Reply to Midkid58
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If he will not HELP himself, then you must SAVE yourself. I don't see any other answer and I would tell him that directly. Your father apparently has no dementia, so you would never win guardianship and he would be difficult to place if you had it. Again, I just posted to a woman with a very mentally ill mother. There are times when there is, in America, nothing whatsoever we can do.
I wish I had an answer of some kind for you. I hope someone does. I wish you the very best.
I wonder if there is a Forum much like this for people with families dealing with the mental illness of a family member. Does anyone know?
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Reply to AlvaDeer
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Messed up, this is in reply to Grandma.

Of course it's time to look for a place, or at least someone to help him a bit more than I can, but what am I supposed to do if he won't go? You, me, everyone, just about, recognizes his difficulties.

But, he's not going, and no one's coming in to help him.

I can't even get someone in to clean his house for him, thankfully it's not in terrible shape but some things aren't working, he can't fix them, and he won't let me do it either. Today, he'll blame Covid, it's not safe to let anyone in, but there will be a different excuse in a few months once everyone's had a shot.

He's just a bleeping bleep about it. Can I swear? Because I really want to.

You are right the meds are almost a side issue. I think he knows he has a problem but he won't face it, "it's just how I am, I'm a worry wart". Here's hoping the GP has a trick up his sleeve.
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funkygrandma59 Feb 7, 2021
You may just have to put a call in to Adult Protective Services, and explain the situation to them, and that you feel your hands are tied, and see what they might recommend. And unfortunately no, we can not swear on this forum. I along with several others have tried(to make our point), but the powers that be have always corrected it.(ie b---h, s--t, etc.)LOL!!!
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To me it sounds like he knows he has a problem, that is why he begged you to get some more of the Zoloft. He knows it helped, but he doesn't like the side effects. Definitely make sure you contact his Dr and see if your dad can try something else. To me the fact that he lives alone at 90 yrs old, and can't see or hear is more frightening than him not wanting to take his antidepressants. Perhaps it's time to be looking for the appropriate facility for him, as then he will receive the care he needs,(and the medications) get to socialize with others to keep his mind off of his issues, and you will have peace of mind and less worry about him in your life. It might just be the win, win situation you're looking for. Wishing you the best.
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