Does Mom need to be on medicine for depression? -

Does Mom need to be on medicine for depression?


She is 97 yrs old and talks about she is old and weak and ready to die, all the time. She is on paxil now and has been on this for years

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Hmm its a toughy isn't it antidepressants or not antidepressants. Here are 2 things people hve said about them:
Antidepressants helped to lift the fog and the feelings I had of hopelessness, and have helped me to feel less like an outline and more like a coloured-in person.
The trouble with this is that in lifting the fog the person can see that they are not gettting better and that can in some people mean the depression is replaced by severe anxiety.
It took me years to find antidepressants that worked for me. Every time I had to change them it was a frustrating wait to see if the next lot would work.
The trouble with this is that as demetia increases so the signs of the results become more about observation than anything else and that is very subjective in some cases.
So while antidepressants certainly have their place - Mum is on them - hey are not the be all and end all and it can be very much a trial and error situation with side effects which can be much harder to deal with.
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I agree with Pamstegma,
Antidepressants are extremely dangerous for the elderly and can make them dizzy, more "depressed", and can make them fall or just become a zombie. She can also take sublingual B-12. Studies have shown it's as effective as shots and costs a h*ll of a lot less. Be sure she's getting adequate supplementation to a healthy diet, including 2-3,000 MG D, calcium and magnesium, etc. Find a local CNC or Certified Health Educator with experience in Geriatrics for advice.
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@Wintersun - I totally agree with you. For my mother it was olanzapine, mirtazapine, and Effexor. She was 89 years old and had suffered depression her entire life. These drugs definitely lifted her mood. Unfortunately, she was in a doctor's office and missed the step going onto the examining table and fell hitting her head and fracturing her pubic bone which landed her in a hospital bed and in rehab where she remains in skilled nursing care. Unfortunately, nothing can be done for her progressing memory loss. She is now in her 92 year.

IF you believe your mother would benefit from antidepressants, I say at least try. Nobody is saying the elderly don't deserve to be happy. Absolutely not true. They deserve the medical care given to everyone. But at some point, we all have to know and understand nothing can be done and we need to allow age to take it's course.
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My mother was on one antidepressant, I believe Lexapro. When they added Remeron, her mood lightened considerably. Some folks needs more than one med for a specific problem; my mom and husband both take more than one bp med.
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I want my mom to be as comfortable physically and mentally as possible. If antidepressants take away the sadness of being old and sick and if all the people she knew and loved have left her, leaving her to feel so alone, then I am all for it. Just have to find the right meds.
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What has her doctor suggested?

Jude and a few others have the right idea...and if I come off as sounding less than compassionate, I'm sorry.

Death is part of life. And at this age, I believe it's totally appropriate to be actually talking about it, not dismissing it. If you continue to tell her not to talk about it, she may just withdraw into herself and not talk at all.

She may need you to help her through this phase in her life...she may just need someone to actually listen to her and her thoughts about death. Perhaps you could ask her what she thinks about death next time she brings it up.
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I agree with dana55452, I would try to get her involved in activities and other things that would get her mind off dying, before I tried another med. There can be a lot of side effects while adjusting to a new med, and at her age that might be hard to take.
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Good grief, I have to agree with JudeAH53 and TooYoungForThis. Between my 86 year old Mom and 89 year old Mother-in-Law, I've heard it all. When the elderly's quality of life (what THEY feel not what WE feel their quality of life is) is such that they feel "tired" of living, you can't blame them. My Mother-in-Law (MIL) is a realist. She's told me over and over in the last year, "I'm tired. It's getting harder and harder for me to get around, hear people (she's lost a lot of her hearing), etc. Dying is a lot of work." Wow. But she's right.

She's done a lot in her 89 years -- raised 5 kids, grandchildren, great grandchildren and great-great grandchildren! Good Lord, the woman needs a rest and she's telling us about it! (smile) I love my MIL dearly and I get what she's saying. She's tired and ready to go. Her ailments are basically that she's old -- no underlying illness to speak of -- just old. I get it.

My mother, however, (age 86), is also hard of hearing (with 2 hearing aids), moves at the pace of a snail, barely eats to sustain her weight, can't see very well, can't hear on the phone, depends on my brother and myself to drive her places, won't give up the check writing duties to me, and she wants to live FOREVER! Her ailments are basically the same as my mother's --- old age creeping up on her. My MIL was quite active all her life; my Mom -- not active at all -- so she can barely walk now because she's never exercised during her life, never worked a job, her friends are all dead (same with my MIL), so exactly what are they living for they're thinking. It's not depression, it's not being fatalistic --- it's being REALISTIC in their minds.

I don't know, bm0508ps, what I said is probably not what you wanted to hear and I apologize if I've offended you, but at 97 years of age, you don't say what your Mom's health status is, but how much longer do you think she has? Just love her and try to be as upbeat as you can. Is she living with you? Is she in a nursing home? Assisted living?

As someone else said on another thread, "I didn't put my parent in a nursing home to die." Well, unfortunately, that's exactly what's going to happen. You try to care for your parents as best you can. When you can't do it anymore, you enlist the assistance of home CNAs, visiting nurses, or get them placed in a nursing facility or assisted living as appropriate. We can only do the best we can, try to not feel guilty about it (boy, THAT'S hard), and love them while they're here. Hugs to you.
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Nutritional approaches to mood balance, are gaining in knowledge and use.
For instance, deficiencies in B12 + Folic are very common, especially in elders.
a B-vitamin form called "5-HTP" can be very good at mood-balancing, as it helps balance neurotransmitters, particularly serotonin...yet it lacks the common adverse effects of the anti-depressant drugs. It's still a good idea to do this under a doctor's observation.

When SSRI's first came out, drug reps told Doctors:
"IF your depressed patient has sleep difficulties, give them the older Tricyclic antidepressants [like Elavil] at bedtime, instead.
Give the SSRI [like Prozac] to the patient who gets good sleep, and have them use it in the morning."
After about a year or two of that, drug reps stopped giving that advice. Most Docs now prescribing antidepressants, probably never heard that, or foot about it by now, it's been so long ago.

Keep in mind, it's OK for an elder to express their feelings about death and dying. They need to be able to talk about it with someone they trust and love.
Death is part of Life.
One of my G'ma's had firm, life-long beliefs in the afterlife; but once she was nearly there, was afraid everything she'd believed was wrong.
She needed someone to be with her, reassure her, touch her, be supportive.
It's kinda scary to be in that position.
Think: How might you reassure anyone who was scared?
She needed to be reassured that she'd be remembered lovingly as part of our lives always.
She needed to know that once her body died, her Spirit was free, therefore would never "miss anything".
I encourage you to talk with her, listen carefully with your heart open, to learn what she's most concerned about.
Then proceed in the conversation as she needs. It can be a gift for both of you!
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My mother was on Paxil for 15 years. She has dementia and was experiencing sundowners syndrome during the later afternoon hours. She used to get very angry, sad and upset. She was very unhappy and also wanted to die. The first time she went to a geriatric psychiatrist, he said that she was on Paxil for a long time and it no longer is helping her. He prescribed an antidepressant. We had to try different ones because of the side affects, but my mother is now on Fluoxetine (Prozac), which is helping her with her moods. She is much happier now.
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