Anyone know about the drug Citalopram for anixiety and depression?

A critical issue is what other drugs is she taking?

@GardenArtist No other drugs or any meds of any kind she was to start Tylenal 1000 mgs. with the Citalopram as soon as tomorrow if oked by me.

Both of my parents, 82, are on citalopram and were place on it this year. It has made a noticeable difference with them. Attitude is what I notice with them but not sure if they had the issues you mentioned. Well not diagnosed anyway but they do not seem to have as many shouting matches. They are NOT nursing home patients although suffering from things such as mobility problems, diabetes, emphysema, arthritis, etc. I ran all of their drugs through a drug interaction website and it said no interference. So far so good.

I myself also take from time to time although not on a daily basis. I take because of relationship issues. It does seem to help get me out of my want to cry spell and helps to lift my spirit. Of course I do other stuff to help as well.

Superecharts, when my doctor prescribed an anti-depressant for me, first she did a DNA test which would let her know what family of drugs would work best with the brain receptors, and this DNA test is my understanding paid for by Medicare.

The turn around on the DNA test is a couple of weeks. Then my doctor gave me samples of one drug to take, the lowest dosage available, and had me cut that dosage in half to start off with. Such drugs usually take 4 to 6 weeks to work.

Medicare does pay for this test. They used it with my hubby to verify his pain meds and whether or not there would need to be adjustments and/or removals.

Thank you answry
I can equate the shouting match to Virginia's loud talking and hollering when her trigger points are happening like the hoyer used to hoist her in and out of the wheelchair and bed.Glad to hear they work for you and your parents thats a plus on the side of Citalopram.

Citalopram 10 mg per day was safe and effective* for my then 88 year old mother with multiple co-morbidities who had become acutely depressed. There are some concerns over 20mg per day if the patient has heart problems, but 10mg will not be a problem; and in any case the problem is an incredibly technical one to do with EKG intervals - way over my pay grade to explain.

*It takes some weeks for the effects to show: you don't just pop a pill in her mouth and magic her back to her normal happy self. Allow a month at least, after which you should see the edge come off her anxiety and bleak misery without any obvious "doping up."

TY freqflyer
The DNA is great idea i may try that one seems like that way the right choice will be made.I like the idea of cutting the dose in half too!

Hello churchmouse
This sounds good: "after which you should see the edge come off her anxiety and bleak misery without any obvious "doping up". She needs relief other wise i am totally against drugs i am getting some insight in a difficult decision of a loved one. Thank you.

Poor lady! I'm sorry for both of you - for her because she must feel so awful, and for you because it's hard to overcome your reasonable aversion to mind-altering drugs. But the clue is in how *disproportionately* unhappy she seems. That's not a natural reaction to being in a nursing home - that's her brain's chemistry getting messed up by disease and it needs correcting, as you say.

I did a quick check for side effects and/or interactions, which MAY occur if any of these conditions exist:

Liver or kidney disorders, heart condition or irregular heartbeat, epilepsy, diabetes, glaucoma, bleeding disorder, manic episodes, any previous allergic reactions to any meds, getting ECT, taking MOA (which doesn't seem to apply here), and/or any other med ( which also doesn't seem to apply, OTC and/or herbal supplements.

I don't know if Tylenol is one of the OTC meds (or even if it's an OTC med at that dose) is one with which it might interact.

I always also check to determine if there are any class action suits against the manufacturer; if there are, that's a red flag as class actions suits require a significant number of people who've suffered a reaction, and last I checked (it's been awhile) must be certified to be a class action suit.

They're not random suits in which someone feels a drug may have caused a certain reaction or side effect, but reflect that significant number of people believe they have suffered from the drug.

Apparently Citalopram is the generic name for Celexa. I also did a quick check for class action lawsuits and PM'ed the links to you.

I think FF's doctor is way ahead of the curve in doing the genetic testing and definitely would consider that before trying a new drug such as Celexa.

It may be a natural reaction because on her floor in the nursing home most patients are on drugs and i would guess Antipsychotic and or depression drugs. Being on no drugs would be harder on her but they do not have a chance of going home Virginia does and i am afraid if i open the door to one drug would i not be opening the door to more drugs.Is there not any just anxiety drugs out there for anxiety only? TY Churchmouse for you comment

Let her take something to feel better. The poor thing.

I applaud your vigilance in caring for Virginia, and in your concern for the potential of additional drugs being added. In your position, I would search high and low for alternatives to drugs to address her depression.

However, she could be weaned off the drug when she no longer needed it.

But I'm wondering if there are other methods? Music and art therapy are noted for their ability to be mood stimulants, and they don't have side effects. Have you tried bringing CDs (or whatever music medium you use) of her favorite music? Coloring? Can she work large piece puzzles?

We played Kate Smith CDs for my mother; my father enjoys Mexican music b/c he was stationed close to Texas in WWII, He also loves polkas. They really gets his feet tapping in time to the music!

Other music, such as harp music, can induce relaxation. During my sister's last battle with cancer, we generally played mood music or light classical at night so we both could sleep.

A few weeks ago I was watching a PBS special on folk songs, during one of their marathon fundraisers. Those old songs were so meaningful, and were so powerful in inducing either calm, peace, recollection or just plain relaxation.

Are there any music programs with visiting musicians in the facility where Virginia currently is? If so, take her to them. Some of the old post WWII songs generate enthusiasm as well.

Once I took my music, brought my mother and an acquaintance she made at the rehab facility, and we went downstairs to where the baby grand was. There were just 2 of patients at that time, but after playing awhile, other people began rolling themselves in in their wheelchairs. It was really a touching moment to see how music affected them.

There's also pet therapy; they have the power to induce relaxation, and can easily cheer someone up in ways that medication can't.

There's also aromatherapy. Cinnamon and spearmint are relaxing.

supercharts, I can fully understand your concern of one drug leading to another. I hate taking any type of medicine, it took a team of wild horses for me to even take aspirin. But as I got older I had to start taking blood pressure pills which I didn't like but eventually my cardiologist was able to adjust the dosage so I wasn't in a fog.

Yes, there are tranquilizers to take for just anxiety, the pills from ages ago one eventually would need to also take an anti-depressant.

GardenArtist
I read all the links about Celexa (Citalopram being the generic name for Celexa) They are informative and i am forming an opinion on what to do about the decision i have to make for Virginia. Your post is full of information so it tool me awhile to post back ty for you for your research.

I am trying to help virginia Sorrynotsorry but have to get all the opinions i can before i decide. My help is never ending for her.

GardenArtist
Exactly what we will do once Virginia is home. She likes to paint and we both like classic oldies i have a ton of oldies from 1920 to 2000.Lots of free time together will also help. Music does help we are in a exercise class in the nursing home and Virginia looks forward to it.

Tylenol 1000 mg every day is way too much.

Will try the Cinnamon and Searment. We used to use Lavender that was very good also ty

freqflyer
Yes thats the word i remember back in the 50's and 60's i think. I was thinking something like that no need for the depression part that whats scares me the sucisides that have ocured with antidepression drugs. TY

This nursing home has mostly* people that are older like Virginia is but on drugs* i do not want Virginia to get on drugs and become sleepy and emotionless all i think she needs is her home that she left with no diagnosis of Dementia at that time that was JUNE 10-16. She was said to have Dementia by the emergency Doctor not her Primary Doctor because she was changing her Primary Doctor next Month May 9 th. Now her Primary Doctor is the Nursing home Doctor who i have not seen or talked to since Virginia was admitted 5-1-16 I will be talking to him in early July. finally. Also Virginia has had 4 bruises the first 21 days that the Health Department knows about but no bruises since. Also getting over bed sores.Now a drug is suggested it seems somehow wrong as she is doing better and looking better than ever except for some loud taking and trying to get the attention of the Nurses Aids because she cannot go anywhere without help.Its a feeling of being trapped i suspect. Is the drug being giving for the convience of the nursing care staff or for Virginia? Another thing is i had a plan for her but it was refused today because of her not being able to do her Activities of daily Living. And by the way i would be there 23/7 one hour for shopping until she can walk again my Son will watch her for the one hour i am gone. I also have a lift for her to transferred from bed to wheelchair and toilet but they think she is to weak i asked for a trial to see but that was refused also. Does seem to me they could do more themselves with no drugs involved. TY for posting Churchmouse.

If you wanted to tranquillise your patients to make them less troublesome, you wouldn't pick Citalopram. It doesn't make you docile or sleepy. Not least because it isn't a tranquilliser in the old-fashioned sense.

Citalopram works by regulating the amount of a specific brain chemical called serotonin which is an important factor in controlling mood. It is one of a family of drugs called Selective Serotonin Reuptake Inhibitors, SSRIs. It is a safe, clean and effective medication in extremely widespread use across the whole population, young and old; and it would probably help Virginia. But if she and her doctors and you felt it wasn't helping, it could be withdrawn safely. It isn't addictive, in that you don't need more and more of it to work and you wouldn't get withdrawal symptoms. The reason it shouldn't be stopped suddenly - cold turkey, if you like - is that the level of serotonin in the brain would plummet if you did that, and abrupt changes aren't what you want. But it wouldn't take long to withdraw a 10mg daily dose in any case.

I think it is difficult to separate out anxiety and depression. I've never found it a very helpful distinction. The person feels wretched - is that because she is anxious, depressed, or both? It's a bit like asking someone to describe physical pain - is it stabbing, wrenching, aching, shooting... It just hurts!

You describe Virginia talking loudly and trying to get the aides' attention because she can't go anywhere without help. You think it's a feeling of being trapped. Is she doing that while you're there? Does she appreciate that you're there? It's just that I'm trying to visualise what you describe, and it's a picture that could fit with dementia.

What was the crisis that took Virginia to the hospital? And was she living with you and your son at the time? - in her home or yours?

Virginia does not act up when i am there she knows we will be active going to her exercise class Tuesday and Thursday, coffee in the cafe,outside for some sun, and talk about how she is feeling etc. She always has a smile on her face when i arrive everyone knows she is waiting for me and i go every day.Virginia had: Bilateral chronic venous stasis,Delirium with possible dementia when i called emergency on April 10-16 she was given 5 mg of Haldol which i was very upset about ! We have lived together for 37 year and we live in the same community for 37 years as well. My Son lives next close by.I am 80 years old Virginia is 85 but we take no drigs outside of my high blood pressure meds.The manufacture of Citalopram is Celexa who was fined 150,000,000 for misrepresenting one of its drug years ago but still not a good sign. Also has some class action suites pending so it makes me wonder. Thank you for the info about Citalopram.

Ah. If I may say so very gently, 'bilateral chronic venous stasis' would not develop suddenly. I am afraid that the NH and Virginia's doctors may have come to the conclusion, based on her having become so ill before, that it is insuperably difficult for you to look after her well enough at home, even with input from your son. I'm very sorry, and I understand your feeling that she would be happier and better oriented at home, but it does sound as if she needs more assistance with personal care and mobility than it is reasonable to expect of yourself.

But it doesn't have to be the end of the world, you know. She is extremely lucky that she can continue to enjoy your companionship and a good range of activities, but in a setting where she has the professional health care team she needs now.

Also, it's early days; and as she becomes more settled in the NH she may well begin to feel better - all that disruption on top of convalescence from a nasty infection (by the sound of it, that is) is bound to have been a setback for her. So why not ask her doctors - next week is it? - if they don't think it a good idea to wait and see before they prescribe.

The Haldol on that one upsetting occasion will have been given to make her easier to manage - but for the very good reason that the paramedics' job was to get her safely and rapidly to hospital and they couldn't take the risk that she might freak out on them en route. I appreciate that it's a shocking thing to see a drug whacked into someone you care about, willy-nilly like that; but it was the safe course of action.

Well, I just had another answer and the site crashed so I lost it all.

I wanted to tell you that I'm concerned about the staffing level, the bedsores, the absence of the primary care doctor, and what plans were made to address the ADL issue when they rejected your plan.

I'm not getting the impression this place offers the greatest level of care. Are YOU satisfied with it?

If you're not, make it obvious by taking notes on everything that you're documenting. They won't know why, but word will get passed around that you are. I've overheard staff commenting when I take notes; the tone of voice suggested some concern.

I've also found that if I don't document and don't address issues right away, problems can occur more easily, meds that are unnecessary or inappropriate are given, and it's harder to reverse than having meetings with staff right away and setting the standards (i.e., in our case, NO substitutions for meds prescribed by the regular treating physicians).

@Churchmouse
Well i did find out that Virginia was laboring more than usual and did make an appointment to see a Doctor earlier but was canceled because Virginia did not want to see this Primary Doctor anymore so i looked for a different Doctor and found one that would see her May 10th i thought it was ok to waitt but she got suddenly worse on April 10 and this all started. I do take the blame for a very bad decision to wait.One i have learned from and will continue to go forward to help Virginia best i can. Haldol in my opinion is never the first choice for an 85 year old women. ty for your comment.

I have the same opinion i went there because in our Apt. building several older women had been there and found it ok it was close to my bus line and i could go there every day so i choice Augustana nursing home.I too became unsatisfied with the nursing staff but give it a try thinking i could be wrong. I have thought of transferring Virginia to a different nursing home but veto'd that because it would be hard on Virginia to start over. It when down hill more until i started to take notes and pictures they all found out about this and i was a looked upon as not be trusted but Virginia's care improved a lot. Sill its below AVERAGE. The social worker said she needed more than ADL was too weak to get on the lift to transfer her i suggested that come over to my home and see in in action they refused, I also asked for a trial run to see if i could take care of Virginia and if not i would send her back to the nursing home, They refused. The one they want is for her to get on a drug. I have refused the drug Citalopram you tube has some bad videos about this drug and a member in her has pointed me to much info on this drug its a bad drug in my opinion.The staff then preceded to give me a list of 3 more drugs to approve. I will look at two only the first drug Celexa is the brand name of Citalopram. I will look into the other two drugs but have doubts as i can approve any Anixiety and Deoression drug for depression which has not been proven she has. They also want Virginia to talk to a psychiatrist because Virginia wanted to tell the social worker that her Father beat her as a child he was an alcoholic. It feel like i am in quicksand and trying to get out. I think i need more help here in Ageing care. After 2 months they are still working on bed sores on Virginia but no therapy planned at all They are working on her mind but no body strengthening its been two *months now.I did talk to the social worker again today i told her if Virginia was out of the wheelchair it just might solve the bedsore problem the depression the anxiety the hollering and the sleeping problem she said the same ole thing Virginia is to weak i disagree with her on that TY GardenArtist for your post

I am curious about something.
If her "trigger points" are when the Hoyer is used to transfer her from bed to chair and back this could be the result of several things.
1. Does the staff take the time to explain to Virginia what they are doing.
2. Do they take their time so the explanation has a few moments to sink in?
3. Is it possible that she is scared during the transfers that she may fall?
4. Is she in actual pain during the movements?
Any or all of these could cause her to yell out.
I do realize in a Re-Hab facility they can not take a very long time due to the number of residents and the limited number of staff. But if they would realize that if you quietly and gently talk to someone while you are doing what needs to be done often the quiet voice and gentle touch can do much more than drugs.
This is not to say drugs will not help but it is possible that a much lower dose could be used along with kindness and understanding.
I know I would not like it if 2 people came at me rolled me to one side, slipped a sling under me, rolled me again and pulled the sling then hooded me up to a big scary metal bar then all of a sudden I am being lifted off my safe comfortable bed or out of my chair. I just might feel safer if someone told me what was going on. Doing this is just as important if the person has dementia. I find my husband is much less fearful when I am telling him what I am doing while I am doing it. I get much less resistance and SURPRISE..that makes my job easier! Win-Win!!