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Re: Help - antidepressant advice for senior? » nona

Posted by JohnX2 on March 9, 2002, at 4:45:18

In reply to Help - antidepressant advice for senior?, posted by nona on March 9, 2002, at 3:47:21


Hi Nona,

I typed this post twice and my computer crashed, so I'll keep
this short before my fuse blows. ;)

I'm not sure what you mean by "zombie", but if you
mean that your relative is just having severe problems
with insomnia at the older age in general and Zoloft is
compounding things then there are some options to consider.

Of the mainline meds:

These are medicines that are likely to startup
insomnia (statistically, in my opinion): Wellbutin,Prozac,Zoloft

Meds more likely to help sleep:
Paxil, Serzone, Remeron

Borderline:
Celexa, Effexor

Remeron is the best "anti-zombie" medicine. And if your relative is
still taking Zoloft I might recommend adding the Remeron on top of the
Zoloft. This will cure the insomnia, remove the zombie effect hopefully,
and give a quicker anti-depressant response. Remeron is also a good stand-alone
anti-depressant (its a little sedating at low doses, less so at high doses).
Also if there is a perception of feeling less depressed but "numb"
on an SSRI, then Remeron may be less likely to make one feel numb.

These are just trends, individual responses will very. And at the older
ages, I'm not as familiar with how people do with medicines. But it sounds
like the medicines that are better for sleep may be the way to go from
your post.

Please discuss the options with the relative and the physician.
The patient needs to feel very comfortable expressing all the concerns
with the physician. Getting well is very important. There are treatments
that can work for the patient, the doctor just needs to be informed of
the patients concerns, ok?

Best wishes,
John

> I have a relative nearing 70 who is very depressed. She became sort of a zombie on Zoloft and is worried about trying SSRI's again for that reason. Wellbutrin is a possibility but since insomnia is a HUGE problem for her I don't know that it would be the best choice. I wouldn't think the tricyclics would be a great option either because of their effects on the heart.
>
> Does anybody have any other suggestions for antidepressants that are safe for seniors? Are all the SSRI's like Zoloft in creating the zombie effect? Are any better in this regard?


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