My Mom’s not eating and her doctor put her back on an anti-depressant for her appetite. Any advice?

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whynotsmile13 Asked March 2014

My Mom’s not eating and her doctor put her back on an anti-depressant for her appetite. Any advice?

I have been taking care of my mom with Alzheimer’s since 2007 in her home. In November, she moved in with me, after a 2 month stay at a skilled nursing facility. A couple years ago, my mom would have short periods of time that she would not want to eat, her doctor prescribed Megace. I would give her a tablespoon for about three days and it would start her eating again…. a couple doses every 4 or 5 months. While in the skilled nursing facility, my mom wouldn’t eat at all, so they gave her the Megace for the whole two months she was there. The week I brought her home, I had to have her rushed to the hospital with a diagnosis of DVT and was told that the Megace does cause blood clots and she shouldn’t have it anymore. In January my mom started not eating again and her doctor prescribed an anti-depressant for eating, one of the side effects to this drug was weakness. My mom started eating again but she was too weak to even move from the couch to her bed with her walker, so I had to use the wheelchair. I took her off this med and things went back to normal for about two months with her eating again. I called my mom’s doctor yesterday and told her that she isn’t eating again, and she told me to put her back on the anti-depressant. My mom still drinks fluids fine, she still knows me and my family, she still uses a walker and she is still a very pleasant lady, I just don’t know if her not eating is her way of telling me that her body wants to shut down. My mom is probably stage 9 for mobility and about a stage 6-7 for her mind. Does anyone have any suggestions for me?

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score 2 · Answer 1

It took awhile for the Mirtazapine to work for my mom's appetite. I was very disillusioned at first because for the first few weeks, it didn't seem to be doing anything. Then it started to work after about three weeks I guess. The problems with these medications are that they help one thing but then have some side effect !!

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score 1 · Answer 2

Mitazapine is immediate onset, so it begins to work after the first pill.

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score 0 · Answer 3

Suddenlysally7, that is the drug (Mirtazapine) that she is on. Her appetite is increasing just a little, but has only been on it for 4 days so far. She was on it in January for 5 days and I had to take her off of it because she became too weak to walk. The only side effect I see so far is the weakness but this time she is still walking with her walker. Ferris1, Thanks for the post, I did wonder how long it takes for an anti-depressant to kick in, I've never taken one or have known anyone that has.

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score 1 · Answer 4

Just keep doing what you are doing, and take one day at a time. This is a terminal illness and she will start to eat less and you need to prepare yourself for the days ahead. For the meantime, keep encouraging fluids and foods and the antidepressant might or might not be "the one" for her. It takes several weeks for it to kick in, and if it does not, you need to try another.

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score 2 · Answer 5

My mom has dementia and went goes thru periods of not wanting to eat. A couple of years ago she was in the hospital for another reason, and lost a lot of weight, cried when she sat down to eat...it was terrible!! I am so sorry for you as I know how frustrating and upsetting it can be!
My mom's doctor put her on a drug called Mirtazapine and it really helped her appetite and helped with her depression. I have not noticed any other side effects. You might want to ask about this drug, if you want to try something else.
Love to you and your mom!!

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score 2 · Answer 6

It's a natural part of the process. Adding drugs only adds side effects. If your mom is comfortable and content (at least as much as one can expect to be given the ALZ and compromised mobility) then, as much as possible, let god and/or nature take over.
I'd be inclined to let her lead. Encourage her to eat, give her tempting choices, but then let her eat what she's comfortable eating.

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score 1 · Answer 7

Have you tried blending real food? Some food blends up into a drink better than you might think, and you can think them a bit with some broth, too.

Beyond that, I'd wonder these things: Does chewing tire her? Are her teeth okay?

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score 1 · Answer 8

There is another med - Remeron - that is supposed to boost a person's appetite. I am not sure if it is like Megace but I think not and it is a newer drug. You could check this out. . .

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score 1 · Answer 9

I agree with Gigi11. Contacting hospice to see if they will take case is a wonderful option for your Mom. As others have said - not eating is a natural progression of Alz. (If anything about Alz is natural). For yourself - I would suggest finding and joining a support group in your area. Also, find a good counselor you are comfortable with and have some chats with him/her. In this process - you count too and taking care of yourself is just as important as taking care of your mom. Best wishes and many hugs.

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score 0 · Answer 10

My mom is on the lowest dosage, 7.5 mg. Does anyone know if you can give anti-depressants every other day? Thought about calling the doctor and asking this....

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score 1 · Answer 11

My mom goes back and forth with eating then not eating. She is now not eating again. She is moving to an ALF this weekend and I am hoping that helps her. She has been in hospice before and almost died from not eating. She even quit drinking. Anxiety meds were given and it helped. She ate and gained about 20 pounds. She came back to eating and feeling better. They discharged her in Novemeber from hospice and now she is back to doing the same thing as before. I am like you, I worry it is her body shutting down as they told us while she was in hospice. I am with you, I don't know what to do either. Take it as it comes I believe.

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score 0 · Answer 12

why not.... ask doctor to reduce antidepressant for the stupor

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score 3 · Answer 13

If hospice will take her case, they'll help with the eating and other decisions. People tell me this takes a big load off the shoulders.

Meanwhile, if a drug causes diarrhea, some experimentation with Imodium could result in balancing this out. Not saying it's easy.

Blessings to you, mother and all involved during this difficult time.

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score 1 · Answer 14

Thanks so much for all the great advice! I will ask her doctor about the failure to thrive and ask for her to be taken off of the anti-depressant. I would rather see my mom go being herself, then her being in a fog.

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score 3 · Answer 15

I also have to agree with Rebecca Lynn. My mother had alzheimers and watching her go through the progression of deterioration was extremely distressing. At some point, you have to let go of what you have no control over and just hold her hand and talk to her when you can. The doctor should call Hospice and they can better help you. My mother got to the point where she asked us to just let her go. I was given a wonderful booklet to explain the process which I found very comforting. Sadly, this is something most of us have to go through in life, and it is very emotional. If you make peace with yourself first, it will help get you through it. It sounds like you have been a good son/daughter, but you can only do so much.

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score 2 · Answer 16

This is called "failure to thrive", which is part of the progession. My Mom went through this for several months. We gave her the protein juices, which are far better than Boost or Ensure. The protein helps to keep the skin from breaking down. In my situation, it was explained to me, that if you try to force them to eat, there is a higher chance of choking. All I could think was that would be a horrible way to pass. My Mom kept smiling and drinking her juice and passed while holding her hand. Ask the doctor about failure to thrive. So sorry for this time, but an anti-depressant sometimes causes more medical issures then to let the process continue. Bless you!

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score 1 · Answer 17

Absolutely NO "insure or boost"... over-processed and filled with GMO sugar those two horrible drinks will do more harm to your loved one.
I make smoothies for my residents who stop eating. I offer it every 30-40 minutes if the refuse , but sure I do not force it. Yes, fresh berries with organic yogurt (no additives!), little ice, mixed with chia or hemp seeds (for protein) make huge difference. Sometimes that appetite comes back. Unfortunately, sometimes it does not. Yes, it's one of progressions of disease and you should not force your loved one to continue eating. It's their way to express that decline.
It might be also sign of their visual decline. Try to use different color china. It might be also helpful if you sit at the table and eat with your mom. She maybe just "forgot" HOW to eat and you have to help her by showing it. If she still struggles to use utensils, use your fingers! It worked for few residents in my care. Again, try to offer all natural non-GMO food instead of processed. Toasted gluten-free bread with coconut oil served with a fruit cup is great option.

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score 0 · Answer 18

I feel for your situation. Sounds like you are beginning to ask yourself if it is time to let go. Is it time for hospice to help you with this? When my mom didn't want to eat, near the end, it was the hospice nurse who helped me realize it was OK to just keep her comfortable with sips of fluids if she wanted them and to let nature take its course. I think it is probalby more difficult for you since your mom has gotten "better" with treatments. I think doing nothing but holding a hand is a more comfortable way to die.

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score 0 · Answer 19

I totally agree with you RebeccaLynn, but her doctor thinks this is the way to go. I’m not so sure about it, my mom is in a stupor all day while on the anti-depressants. How do you go about just not letting them eat?

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score 2 · Answer 20

My husband's dad had alzheimer's and he slowly just stopped eating. I don't want to upset you, but I think it's just a part of the progression. His dad was in hospital/hospice at the end and they explained it in more detail. He never appeared to be suffering , if that helps you at all. :)

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score 0 · Answer 21

Unfortunately we have tried this and it only gives my mom diarrhea, so we had to stop using them.

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score 0 · Answer 22

If she is drinking fluids, give her liquid meals like Ensure or Boost. The MD can order these for her.

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My Mom’s not eating and her doctor put her back on an anti-depressant for her appetite. Any advice?

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