My 84 year old mum is severely depressed

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My mum has COPD she's 84 and being treated for depression and anxiety, she's been prescribed sertraline 150mg but the doctor upped the dose to 200mg a few months ago because she was still feeling anxious, now she seems unable to stand on her own and constantly complains of a funny head where the room spins the doctor thought she had vertigo and gave her a weeks medication to see if it made any difference it didn't now they have decided to taper off the sertraline and start her on 5mg mirtapazine ( not sure of the spelling) to eventually stop  the sertraline  and up the dosage of mirtapazine this was started last week, mums felt so much worse since then and I'm wondering if it's side effects from the drop in meds I have read on here there is something you can take to stop the side effects but I can't remember the name can any help with the tapering of one med and starting on another it seems she's not been herself for two years since the depression

and anxiety set in she's coped with her COPD for 15 years but always been mobile since she was started on these medications she's become a different person I feel like her mum instead of the other way round why do these doctors chop and change her meds with no consultation or information about how it might affect her they know she lives alone she just sits in the couch or stays in bed all day feeling terrible is there anything I can get her to help this situation


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  • Posted

    Dear Sue,

    Not sure if I can help.

    I have been on anti depressants and anti anxiety med's for 18 years, including Sertraline and Mirtazepine.

    The old school method of transferral from one to another used to me, stop taking the 'old' one, one day, start the 'new' one the next. This thinking has changed to weaning over the last 10 years.

    I preferred the old school method, but it is now known that it can lead to Seratonin Syndrome, which is effectively an overdose of the Neurochemical that the anti depressants work with.

    To my knowledge, and I'd love to know if I'm wrong, there is no medication to aide weaning.

    I personally find Mirtazepine to be a slightly more effective medication, and marginally better with anxiety, although it is not an anti anxiety in it's own right.

    Common anti anxiety prescriptions include Diazepam, Midazolam, Pregabalin (the most effective in my experience), or in 'advanced' states, Propofol (I have this for surgery because I can't take General Anaesthetic).

    There are a couple of natural anti depressants, including St John's Wort and 5HTP, but these CANNOT be taken in conjunction with prescribed anti depressants. Banana's naturally create Seratonin (the 'happy' brain chemical), and will not contraindicate with prescribed med's.

    There are a number of natural anti anxiety treatments too, including L-Theanine (a natural element in tea), lettuce contains a natural, but gentle sedative, Valerian Root Extract, Ashwaghanda (an Ayervedic herb remedy), Rescue Remedy, and Meditation being my number 1.

    Any necessary information about potential side effects either whilst taking med's, or weaning off them, should all be contained in the Patient Information Leaflet that comes with all medications - if your Mother's prescriptions come without these, feel free to politely ask your Pharmacist why they have not been included.

    If in doubt, all PIL's are available for download online.

    Have her Vitamin D levels been checked? If she is not able to get out, it is possible that her mood is being lowered further by low Vitamin D intake, this can be helped either through getting her outside for a minimum of 15 minutes each day, a prescription of Colecalciferol 800 unit tablets, or a good multi vitamin from any good chemist. If you ask her GP for bloodwork, or any referrals, it is good to know that legally they cannot refuse your request, so long as it is in alignment with your Mother's wishes.

    Google has some good information on treating both depression and anxiety with diet (Channel 4 did a great two part documentary called 'The Food Hospital', unfortunately, to my knowledge, it's not available online, but a lot of the information included is out there, separately).if you Google 'foods that are good for depression' the fifth link is an NHS one, I'd advise starting there.

    All best wishes, love and hugs,


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  • Posted

    An afterthought that I meant to include.

    If in doubt of any contraindications of any medications, I use a great site (this site won't let me post links, so I hope you can work out my 'code'!) w w w dot drugs dot com. You can look up both prescribed, and natural remedies on this site, put in her full list of meds, hit 'go' and find out if they are interferring with each other, on any level. xx

    I hope some

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  • Posted

    Sorry for 'bitty' responses, started this on my phone, then lost it all, so trying to regather my thoughts.

    From an Aromatherapy point of view, Lavender (alo a calming, anti anxiety effect), Geranium and Rose are natural anti depressant scents, so perhaps put a couple of drops of essential oils on her pillow or clothing. I'd advise against burning insence or oils with a patient with COPD.

    I really hope at least some of this helps your Mother.

    Love, hugs and best wishes, hanb

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  • Posted

    Hi Sue I am quite new to this blog - your mum has coped with COPD for 15 years and got on with her life - this is brilliant  These new drugs must surely be discussed fully with her GP especially side effects =- all or most anyway of an anti drepressant drug can do as much harm as help - Mirtapazine in my drug boo states it is an straight anti depressant (no more info on that particular drug) if it were my Mum I would make a appointment get Doctor to your house and get him to spell it all out - more importally why is she so depressed?? Good luck Dawn
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  • Posted

    Dear all thanks for your responses it's given me some ideas on how to help her, two years ago she had a series of viral infections and was so bad she was taken into hospital she was unconscious for a week and when she came round she was unable to get out of bed and had  no knowledge of why she was in hospital she was so weak she couldn't hold a cup or do anything for herself and she list her dignity with nurses having to do everything for her, she ended up there for nine weeks then had to be admitted into a rehabilitation hospital for another five weeks to learn how to walk again when she eventually came home she still couldn't look after herself and had to have social services involved to help her, I think during all this she suffered post traumatic stress and hasn't improved since then, her doctor was treating her for depression and anxiety as well as COPD despite all the antidepressants she's taken nothing has changed I know her life us nothing to what it was before
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  • Posted

    But we have tried so hard as a family to sort out her medications but the doctor keeps changing everything and going back to meds she's tried before that havnt helped they havnt said anything about the side affects of changing but her symptoms sound like withdrawal to me I have tried to speak to the surgery but they will only discuss this with mum the problem is mums gone deaf and can't understand what they say to her she is also taking diazepan I just wish I could understand better what could help her but thanks again for the advice and kind thoughts I will check these out


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