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OzarkOlly Asked August 2015

Is there something better than Seroquel for anxiety/depression in the elderly?

My 84 yr old mother with dementia has terrible anxiety & most likely depression as she'll either burst out in tears for no reason or will tell me that she feels close to tears but doesn't know why. Her doc put her on Seroquel 100mg but I was suspecting it was *causing* more issues than it's curing & now I'm convinced it is. She's been on 50mg, it's not really doing much for her anxiety & tearfulness & she gets REALLY loopy after taking it. I've tried bumping her to the 100mg to see if the anxiety & tears will decrease but she gets SO confused that she doesn't make ANY sense at all. For the past 3 nights I haven't given the Seroquel and, while she still sundowns a little, it's *definitely* not as bad as when she takes the Seroquel. Ativan seems to help with the anxiety but, of course, isn't helpful for the tearfulness/depression. Secondly, her doc is less than willing to prescribe Ativan as a routine dose. She tried Zoloft but that gave her diarrhea so bad that she was messing her pants. Any suggestions of meds that have worked for you guys that I can ask her doc to try?

Mulata88 Apr 2016
Let me vent here.
I am 54, depressed, taking care of 72 yr . old hubby and 91yr.old mom.
Had insurance coverage for Cymbalta 60mg.
As of
January 2016, I have a different insurance all together.
Cymbalta, not on the formulary.
Doc substituted for Efexxor.
I have had the worst day of my life and a nervous breakdown.
I have been doing great on Cymbalta.
I spent all morning and afternoon being bounced back and forth between the doctor's office STAFF, insurance and pharmacy to get my Cymbalta approved.
I got so overwhelmed by the way I was being treated, and I didn't want mom to worry. Husband sick in bed, worst sore throat.......
I was sobbing uncontrollably at one point, about some pre auth, and the person who was helping me out, finally got it right.
Efexxor is worthless.
Cymbalta works.
That's my own personal opinion, and I am not giving medical advice.
Just commenting on what happened to me today! Grrff sniff, sniff, ggggrrrr.

Mulata88

BarbBrooklyn Aug 2015
Effexor and Cymbalta are both SNRIs, a different class of drug from Zoloft, which is an SSRI.

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OzarkOlly Aug 2015
Angela11...yes, I thought the symptoms she's getting from the 100mg Seroquel might have been dose related so I cut one of her pills into 4 pieces to make 25mg doses and, while she was a bit less loopy, it wasn't enough to deal with the tearfulness.

Sunnygirl1...thanks for your insights regarding Celexa. I'm gonna do a bit more research but it sounds like it might be one to put near the top of the suggestion/request list.

What about Effexor? Anyone have any experiences, good or bad, using that in the elderly?

Sunnygirl1 Aug 2015
OzarkOlly,
I feel your pain. My loved one acted a lot like yours does before she was placed on Cymbalta. It was like a miracle med for her. Without it, she is anxious, crying and could not say why. On it, she is content, happy and does not seem anxious at all. I have been very impressed with this med. I would highly recommend it. It also treats pain. Several people said good things about it, before my cousin went on it. There were right. Of course, it depends on the person, but for some this medication is invaluable.

Angela11 Aug 2015
I'm a pharmacy technician and I haven't seen many good results reports with quetiapine (brand Seroquel) it's commonly used in nursing home (to keep patients quiet in addition to hopefully relieving abxiety) still 100mg is a high dose 25mg being commonly used.
I would ask your doctor about trying Risperidone, a low dose 0.5mg relieves anxiety in a lot of people and used quite a lot in UK. I agree with a previous reply as well that a low dose antidepressant could help.
Not liking to disagree with your Dr but it doesn't sound to me like Seroquel is doing a good job.
Good luck.

BarbBrooklyn Aug 2015
Olly, I apologize, I didn't realize this was you, in the one stoplight town and all. Please forgive my "big city" point of view.

So, anyway, Remeron has been touted to me as a really good med for elders with depression and anxiety, although not being a dictor, I can't tell you why. The combo of lexapro and Remeron has been a real blessing for my mom, with a low dose of klonopin for anxiety.

I know someone else on here has had good experiences with Celexa, as well. Perhaps your doctor can get samples?

OzarkOlly Aug 2015
The Zoloft was prescribed 2 years ago by a different physician in her home state, she was only on it for a few months & hasn't taken anything since. The Seroquel was prescribed by her new doc here in my state because of the severe anxiety & it was a reasonable choice because it does have an indication for Generalized Anxiety Disorder.

I live in a town with a population of less than 250. We don't even have a stoplight so we feel pretty lucky to have basic family docs & basic emergency care so, no, there's no such thing as geri psych in this area. Doesn't matter anyway because her doc back home tried to get her to see a Psych & she refused...said she wasn't crazy & disn't need it.

And while I don't disagree that her DOCTOR is/should be knowledgable, it never hurts to gain real world experience & knowledge from others that might end up leading us to the right medication faster! No sense spend months muddling around trying meds that don't have a good track record of success. I know not all meds work for every person & that one of the lower success meds might end up working best for her, but it's not likely so I'd rather try others that have a good success rate first & work my way down the options from there.

BarbBrooklyn Aug 2015
Lexspro, Remeron are both good for depression and anxiety.

BarbBrooklyn Aug 2015
Here's the thing. Her DOCTOR ought to know enough about meds and her mental condition to not need you to do suggesting. Is this a geriatric psychiatrist or at least a geriatric specialist? There are so many SSRI and SSNI drugs on the market...if not Zoloft, then there are 20 others. You need to ask why he went from Zoloft (an SSRI antidepressant ) to an antipsychotic, which is what Seoquel is.Does he assume if mom had diarrhea from one antidepressant, they would all do yhat? You may need a better doctor.

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