Just tell her how you feel, instead of trying to plan on medications that may or may not work. If she’s feeling blue about aging, trying to take away her agency will only make it worse. Maybe it’s just a season? We all hand them.

Why do you think they would work? I am a lifelong anxiety sufferer, no depression. The only times I have had depression in my life, to the point of suicidal thoughts, was when I was prescribed the so-called "anti-depressants." They also gave me physical side effects, really bad for a person whose anxiety manifests somatically.

Paxil withdrawal is very unpleasant—don’t just cut off this med

Anonymous wrote:

Anonymous wrote:NP, but does everyone think PCPs are fine to handle medication for low-level depression and anxiety? I need to switch my dad off of Paxil (explained below). I don't think mine or OPs parent would do the psychiatrist route! Thanks!

====longer post=====
My father with dementia has been on Paroxetine (Paxil) for 10 years and now I learn it's known as an "anticholinergic" (can cause poor coordination, confusion, basically exacerbate dementia).

I'm upset bc withdrawal off of it is terrible, so now I have to help my dad tackle that.

Does you parent have a neurologist (maybe for migraines or something)? It would be better to have someone with lots of experience with the elderly. Does PCP have lots of elderly experience? Are you sure it's worth weaning him off? Does he want that? Yes, with other meds there are fall risks as well. You have to weigh pros and cons. Are you sure he doesn't have low level anxiety on meds and major anxiety off them? Does his mental health issue repel people when he isn't medicated. Think long and hard about how things will look off meds and the fall risk may be the least of your problems. Is this driven by him or you?

Thank you so much for this response (and another PP for mentioning starting a new med to help the withdrawal). So many great points. He has a PCP who is not a geriatrician but serves the elderly, and also has a neurologist for the dementia.

Dad doesn't even remember why he started Paxil, asks what is for and just kind of says oh, well, whatever. We've just kept going because I knew withdrawal would be really terrible (brain zaps, etc).

It's only 20mg, maybe I shouldn't be concerned that it could be worsening his dementia symptoms? His main neurologist knows about the med and glosses over it, and a second neurologist said he could taper off since my dad mentioned brain fog. But didn't pursue because I know he would need a care plan (maybe even liquid so he can taper slowly).

I'm a huge proponent of meds, and do think my dad would benefit from even more support in this area, but I am concerned about this specific med being an "anticholinergic". He doesn't even take ditropan for incontinence since it might impact memory.

I think I should get him into a geriatrician who can help weigh all these things. Just want his mind to be as sharp as possible for as long as possible.

Thanks again and thanks to OP...I borrowed your platform.

Anonymous wrote:NP, but does everyone think PCPs are fine to handle medication for low-level depression and anxiety? I need to switch my dad off of Paxil (explained below). I don't think mine or OPs parent would do the psychiatrist route! Thanks!

====longer post=====
My father with dementia has been on Paroxetine (Paxil) for 10 years and now I learn it's known as an "anticholinergic" (can cause poor coordination, confusion, basically exacerbate dementia).

I'm upset bc withdrawal off of it is terrible, so now I have to help my dad tackle that.

I don't know if it would apply to your dad's case, but when switching from one antidepressant to another doctors can sometimes reduce the old one while building up the new one to reduce withdrawal symptoms.

Anonymous wrote:NP, but does everyone think PCPs are fine to handle medication for low-level depression and anxiety? I need to switch my dad off of Paxil (explained below). I don't think mine or OPs parent would do the psychiatrist route! Thanks!

====longer post=====
My father with dementia has been on Paroxetine (Paxil) for 10 years and now I learn it's known as an "anticholinergic" (can cause poor coordination, confusion, basically exacerbate dementia).

I'm upset bc withdrawal off of it is terrible, so now I have to help my dad tackle that.

Does you parent have a neurologist (maybe for migraines or something)? It would be better to have someone with lots of experience with the elderly. Does PCP have lots of elderly experience? Are you sure it's worth weaning him off? Does he want that? Yes, with other meds there are fall risks as well. You have to weigh pros and cons. Are you sure he doesn't have low level anxiety on meds and major anxiety off them? Does his mental health issue repel people when he isn't medicated. Think long and hard about how things will look off meds and the fall risk may be the least of your problems. Is this driven by him or you?

Anonymous wrote:Similar problem with my hypochondriac father who consults his doctors for everything... except his out of control anxiety.

How can I get him to realize he has anxiety, and how can I make him take meds?

Been there, As mentioned you go through the doctor and sometimes it's just a matter of hitting rock bottom sadly. My experience is my parent would take meds, feel much better, decide meds weren't needed go off and spiral down and the cycle kept repeating. I had to learn to accept I cannot make parent happy and I cannot force meds. All I can do is have my boundaries. I will say the out of control anxiety can definitely be dementia/Alzheimer's related too and even an early sign. It is really hard to let go and just allow a parent to be miserable and not be able to make it better. You can do anything within your control including contacting doctors, but if your parent is considered cognitively OK, then you just have to accept the choice not to be on meds.

NP, but does everyone think PCPs are fine to handle medication for low-level depression and anxiety? I need to switch my dad off of Paxil (explained below). I don't think mine or OPs parent would do the psychiatrist route! Thanks!

====longer post=====
My father with dementia has been on Paroxetine (Paxil) for 10 years and now I learn it's known as an "anticholinergic" (can cause poor coordination, confusion, basically exacerbate dementia).

I'm upset bc withdrawal off of it is terrible, so now I have to help my dad tackle that.

Similar problem with my hypochondriac father who consults his doctors for everything... except his out of control anxiety.

How can I get him to realize he has anxiety, and how can I make him take meds?

I posted before, but should mention that reminds me of the descent into dementia with both my parents-especially mom. She got very angry and had quite the mood swings. Both had phases of apathy. My dad definitely had phases where he didn't care at all about grandkids or his own kids and would pick up a newspaper and read as we tried to chat. It was kind of funny in his case and other days he was more social.

Going off on a tangent here, but I can still picture my dad in the middle of the summer, insisting on wearing many layers (another dementia thing) as his grandaughter tries to share one of her long drawn out stories he used to love to hear and he picks up the newspaper and ignores her. Luckily we prepared her so she wasn't offended. Instead she went to the other side of the newspaper and then he covered that area. She just kept shifting and he kept shifting and we all started laughing not at him, but just at the insanity of it all. He thank goodness wasn't combative. Mom is very combative and can be quite scary.

Let her doctor know your concerns so the doctor does a screen and asks questions. Mention going the pain management route or as a treatment for another ailment like headaches perhaps? SSRIs are prescribed for all sorts of things. Also don't enable or reinforce. My therapist had to help me step back. By doing all sorts of things hoping to "rescue" mom and improve her mood, I reinforced staying stuck. When I stepped back and only reinforced positive measures (seeing her friends, getting exercise, etc) she did eventually hit rock bottom and admit to her doctor she was struggling...after the doctor kept probing.

We just added it to my mom's other meds. Geriatrician gave it to her.

Many antidepressants are cross prescribed for chronic pain

You can stretch the truth. I tell my parent that it is medication to help relieve signs of aging and improve morbidity. That is all true. Treating mood disorders helps improve life expectancy. It's just not the only thing

Over the last few years my Mother (73) has had some health issues and needed several surgeries. During this time she got a "woe is me" attitude, gotten mean, withdrawn from friends/family. She takes a lot out on my father who is her caretaker at this point. He is an eternal optimist but even he is getting worn down from her. Her health is at a stable place finally but her attitude hasn't changed (like she kept saying it would). She jumps down my Dad's throat when he mentions talking to the doctor about meds for her mood. It's hard to see her not care about things she used to, like talking to grandkids, gardening, socializing, traveling. All she wants to do is read books and watch TV. I feel like she is giving up on living and taking my Dad with her because she's so dependent on him. Is there anything we can say?