stopping anti depressants

[Tin]

Just thinking out loud here, but at what point, are anti depressants stopped or are no longer helping?

 

[Tin]

Do you mind if I ask are you talking for yourself as a carer or a person with dementia?

Sorry, should have made that clear. My mum with dementia. Because of the stage she is at now, I am wondering about the anti depressants. we have what will probably be our last memory clinic appointment in January and will discuss this with them, but for now I am sitting here just wondering about how long and so on.

 

[jenniferpa]

If you're talking about ssri's then I would say when there is evidence that the person has too much serotonin circulating. There's something called serotonin syndrome which I have had, albeit mildly. In my case the most obvious symptom was an incredible craving for sugar: I ate an entire pot of jam with a spoon and then thought just a sec? This isn't normal.

 

[Tin]

If you're talking about ssri's then I would say when there is evidence that the person has too much serotonin circulating. There's something called serotonin syndrome which I have had, albeit mildly. In my case the most obvious symptom was an incredible craving for sugar: I ate an entire pot of jam with a spoon and then thought just a sec? This isn't normal.

Wow jenniferpa very useful info there. Mum's anti depressant is in that group and I have noticed some of the symptoms, of course it could also be just dementia. Will talk to gp sooner rather than later. How did they discover you had too much serotonin circulating?

So I guess there is a point when the anti depressant no longer helps and in some cases can cause problems.

 

[jenniferpa]

In my case it's because I need less medication in the summer. But you are right: it's tough to work out what might be dementia and what might be down to what is essentially an overdose of ssri's.

As to discovering: I have a very on the ball psychiatrist when it comes to medication, but really it came down to: hmm, let's see what happens when you reduce the medication a little. So basically trial and error. I don't think there's a blood test or anything.

 

[Tin]

In my case it's because I need less medication in the summer. But you are right: it's tough to work out what might be dementia and what might be down to what is essentially an overdose of ssri's.

As to discovering: I have a very on the ball psychiatrist when it comes to medication, but really it came down to: hmm, let's see what happens when you reduce the medication a little. So basically trial and error. I don't think there's a blood test or anything.

thank you, It is just that I am noticing some really unusual things and as is the normal in my household I look at everything.

 

[marionq]

The thought of my husband coming off his Trazodone fills me with dread. That is what has got us through the last three years and I would fight tooth and nail to hang on to it.

 

[ianrut]

Just thinking out loud here, but at what point, are anti depressants stopped or are no longer helping?

I was looking after my wife Mary 24 / 7 and barely coping .Doc prescribed mirtazapine 6 months ago . Mary now in nursing home and I am feeling better .
i am feeling alone and sad but stopped the pills. I think they had side effects eg dizzy, bad walking because I am getting my mind and body back to normal.
My doc said to try half dose and the effect felt in a couple of weeks give it a go

 

[Risa]

My Mum was on an anti-depressant before she was diagnosed and this was for pain relief due to a bladder condition. She wanted to come off of them (and thinking about it now, I wonder if she suspected there was something wrong with her mind and thought the tablets were to blame). So with the GP's approval, she started to cut down the meds gradually over a period of a few months. However what we did find out was that the tablets had masked a lot of her dementia symptoms and when she was finally off the anti-depressants it was horrendous. She had to go back on them straight away as she was crying all the time, rocking back and forth, saying her head felt heavy, shuffling instead of walking and refusing to eat. After this, she was formally diagnosed at the advanced stage So please proceed with caution if you decide on this course of action as I think some GPs underestimate how powerful the drugs are. Don't let them rush the process.

 

[Tin]

Just to let you all know that I am not planning to withdraw mum's anti depressants, at this point I am just wondering if at a certain stage in dementia do they become useless, but I am going to talk to gp and memory clinic about the pros and cons. I have had this conversation with them before and the answer that came back was that if we withdraw then some of mum's bad obsessions will return. I suppose what will be needed is another tweak, but down instead of up, maybe?

 

[Nebiroth]

The basic answer is usually when the doctor is confident the depression has gone and won't return if the medication is withdrawn. If this is not the case then anti-depressants can be continued on the basis that this will not actually do any harm. Moreover, anti-depressants of the SSRI type (the most commonly used) have many useful side-effects, because serotonin levels have effects throughout the body, not just within the brain; it is often not clearly understood why anti-dpressants benefit patients who aren;t depressed but who have other problems, but it is known that they do.

Serotonin syndome is rare, and is usually caused by high doses of one or more drugs.

Whatever the case, continuing an SSRI is unlikely to be harmful, and it is hard to judge the mental state of someone with dementia. Some SSRI's are also anti-anxiety drugs, without the drawbacks of what are commonly called "tranquilisers". Drugs like valium quickly lose their beneficial effects and have dependency issues

Regardless, any withdrawl of an anti-depressant must be done very gradually, under medical supervision. Suddenly stopping treatment can cause some very unpleasant side-effects.

As you note in your mum's case, the anti0depressan tis actually being used to help with her obssessional behaviors. As the root cause is organic damage to her brain due to the dementia mechanism, it is quite possible that withdrawing the drug would cause these to return.