JennaS: 85 yr old Mom, 50 mg of sertaline for 3-4 years

[JennaS]

My 85 year old mom has taken 50 mg of sertaline for several years.

2 months ago, for about 3 weeks, the nursing home increased it to 75 mg.

I took her home to live with me,  then for about two weeks I reduced it back to 50 mg

5 days ago I reduced it to 25 mg.

Now that I have found this forum, what should I do now, to start tapering?  Should I keep her on 25 mg and go from there, or should I increase it up for awhile and then start tapering. Since I just found this forum, it will take me awhile to read & understand everything I am supposed to do,  but just hoping I can get an answer today, or soon, on where I should start with the tapering.

 

[Gridley]

Welcome to SA, JennaS.  We're happy to help you and your mother with the Sertraline.

 

I have a few questions:

 

1.  Why did the nursing home increase the dose to 75mg?  How did your mother respond to the increase?  Did they increase the dose because they thought it had ceased to work? If so, why did they think this (if you know)?

 

2. Why did you reduce it back to 50mg?   When you reduced it back to 50mg, how did your mother respond to the decrease?

 

3. When you dropped in to 25mg, how did your mother respond? How is she feeling now?

 

4.  How is she doing on the Sertraline recently as compared to previously over the years? 

 

5.  Why did you decide she needs to taper?

 

6.  Over the 3-4 years before the nursing home increased the dose, how did your mother do on the drug?  Did she have side effects?

 

The drop to 25mg was a 50% decrease, putting your mother at risk of withdrawal symptoms.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

Your mother has undergone a number of dosage changes in a short time, and what she needs now is stability.  Since she's been on the 25mg for only 5 days, I would go back to 50mg and hold there her symptoms are stable. This might take some time.  Do not rush into a taper.

 

We recommend tapering no more than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Sertraline, including how to get the non-standard doses you'll need for a 10% taper.

 

Tips for tapering off Zoloft (sertraline)

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you can answer my questions, ask your own questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

 

[JennaS]

The nursing home did that without my approval, even though I had told them that I was planning to wean her off it. So it was upsetting.   Not sure why they did that. My guess is because  she was only there for such a short time, and she reacted prettty badly to being there, i.e. seeming really down & depressed but that was most likely just because it was all new to her and we basically left her there alone because of some things going on in our life.  When I picked her up from the nursing home she seemed like a zombie, almost like nobody home.

My sister put her on the drug several years ago (with agreement from her doctor) several years ago because she thought my mom was depressed, after my Dad passed away.   I never agreed with that plan but my sister was managing her when my mom lived in Florida.  Now she has moved here with me to Georgia and I would like to take her off it because I don't think she needs it.   She never had any strong mental issues (depression, etc) her whole life and has never had any of those issues such as what I've have read about on this site or others.  So I feel giving her this drug was a mistake.

When I reduced her back to 50 mg I didn't notice any issues.  But the last few days on 25 mg I noticed her different the first 2-3 days:  She had an enormous amount of mental energy.  It didn't seem negative but she was very wound up,  That seems to have settled the last few days and she seems back to normal now.  

I'm not sure how she has done on 50 mg that last few years, as far as I'm not sure what the difference would be if she was not on it.  She seems happy overall  (which is normal for her), but I always felt it was a weird kindof happiness that didn't seem quite normal (but just my opinion).  But her dementia has really increased in the last 6 months so it is hard to tell sometimes what is really going on with her, or the cause of certain actions.

As far as my reasons for tapering, since I wanted to take her off it, I had heard you have to do it slowly, so that's what I thought I was doing (and he doctor told me just go down to 25 mg for a week!).  But since I saw your website I became concerned that I was doing it too quickly.

Thank you so much for your response.  I will increase it back to 50 mg and go from there, if you still think that would be best.

[Gridley]

1 hour ago, JennaS said:

will increase it back to 50 mg and go from there, if you still think that would be best.

That's what I would suggest.  I don't want your mother to have withdrawal symptoms from too fast a drop.  Then, when you feel she is stable on that dose, you can start a 10% taper down to zero.

[JennaS]

Thank you very much.