antidepressants(1)

odowd

Just wondering if anyone else has experiences they can share with their PWD on antidepressants. 

Mom has been in SNF for about 10 months and gets very depressed just about every day. She complains about having nobody to talk to and nothing to do (even though the facility has lots of activities every day). She gets sad about not being able to go anywhere or do anything, which I interpret as a mix of her feeling restricted by being in a facility but also just general depression over getting old and hurting all the time, not being ambulatory. 

She was started on Cymbalta at the start of the year; the psych NPs went with that one because it can also help with pain management. Through consultation with the psych NP, we have increased her dosage several times over the past seven months. But still she cries, says everything is falling apart, that God is telling her it's time.

Has anyone had experience with Cymbalta for PWD, and/or found more success with something else?

dayn2nite2

Seven months and multiple dosages would have me asking if another medication could be tried.

If she needs something for pain, they can address that separately if they want.  My mother was first on Prozac, then Effexor, and the Effexor was very effective.

Her feelings, that everything is falling apart, aren't off base.  They're normal.

Is the staff making an effort to bring her to activities/gatherings?  They're not just asking her yes/no and accepting no?

​fesk

I agree. I would ask for a different medication to be tried at this point. I can't recommend anything because each person reacts so differently. 

Best of luck - keep us posted.

MN Chickadee

Anecdotally it seems to me most PWD take mood altering drugs. Usually an SSRI at minimum, others need something stronger like Seroquel. Every PWD reacts differently to drugs and it can take some trial and error to find the right one or combination to improve quality of life. I wold definitely ask to try something new after that many months. With my mother with Alz we eventually found Celexa (generic is citalopram, which is an SSRI) combined with mirtazapine was the right combination for her. The mirtazapine she actually took at night for sleep but it is technically an anti-depressant. It also helps with appetite stimulation. I see Zoloft mentioned on these boards as well.  I have a friend whose mother has dementia, and when they switched her off prozac to a different anti-depressant it was like a light bulb came on, she was much more alert and happier. Life changing. Clearly that was not the right drug for her but they didn't realize it wasn't disease progression until they tried stopping it. So it's definitely worth asking the doctor to tinker a bit more.

odowd

Thanks all for the suggestions. Yes, it's been a long time but it's because she was started at 20mg once a day, then twice a day, then 30mg twice a day, to now 30mg a.m. and 60mg p.m. And so with each adjustment, I've been told it can take several weeks to see any benefits. Hence here we are seven months later.

It's now been about a month with the current dosage, so it might be time to talk to them about trying something else. 

odowd

Just wanted to share an update that I spoke with the psych NP earlier this week and we are tapering mom off the Cymbalta and switching to Effexor. We'll see how that goes and I will share what happens. Fingers crossed!

​fesk

Best of luck odowd. Let us know how it goes.

dayn2nite2

I'm glad they're going to try something different - let's see what happens.  Not that it's going to predict how your LO will react, but my mom perked up considerably within a week of starting it.  I hope the same goes for yours.

odowd

I just wanted to share that after weaning mom off the Cymbalta, she's now been on Effexor for about 10 days. While I don't want to get my hopes up too soon, I've noticed a significant change for the better!

Last night she called around 7 p.m. (I could set my watch by her phone calls). We ended up talking for over an hour. I was nearly in tears by the end because it was such a good call. I can't remember the last time she was HAPPY and laughing in the evening. Saying how much she liked where she was, how nice everyone is. She even said she was going to ask about getting a shower today. (Her resistance to showers has been a major issue since going to SNF.)

Maybe this was an anomaly, maybe I won't have a call as good as that one ever again. But I had it last night. 

dayn2nite2

Wow!  Fingers crossed it continues!

Martin Robbins

Thank you for being so involved with your mom's care.

Tough part is that finding the right medication is hit or miss.  I tried several SSRI medications prior to settling on Zoloft.  My mother w/ Alz was also taking Zoloft, and it worked to lighten her mood considerably.

I echo dayn2nite2; address the pain with a separate drug dedicated to that end only.

​fesk

That is great news. Hoping it continues.