Best "Senior" Antidepressants

Posted by briarrose @briarrose, Oct 29, 2023

I just posted a question re: weaning off Paxil 10 mg. and with my reported "brain fog" forgot to ask a further question. Sorry about that.
I am in search of a new antidepressant for my severe anxiety and depression. I was on mirtazapine 30 mg. for 22 years and found through GeneSight I was not metabolizing it at all. Thus the switch to Paxil 10 mg. which is not really working well for me. I am a female, 68 years old and sensitive to all medications. Any thoughts on what is tolerated the best for seniors? I will run this by my psychiatric nurse practitioner of course but reaching out to others for thoughts.

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@rosebookay

More likely the Zoloft.

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I have been on Zoloft for at least 2 years now & never experienced burning feet & ankles. It used a lot in the senior population because of low & benign side effects.
It’s not the Zoloft.
John, see a neurologist for this issue.

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@briarrose

I have been on Zoloft for at least 2 years now & never experienced burning feet & ankles. It used a lot in the senior population because of low & benign side effects.
It’s not the Zoloft.
John, see a neurologist for this issue.

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Low and benign side effects?????? My father had a major gastric bleed and died from it. It also causes low sodium in seniors which can be deadly. I’m glad you have had good results but it is hardly a drug of low and benign side effects. And….yes they can precipitate neuropathy particularly by raising blood glucose levels.

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@briarrose

Yes, I hear ya’.
There are always trade offs with most things in life.
I feel that being in our 70s, we already had lots of past sexual activity in our lives. But a feeling of mental wellbeing is paramount at this stage of life, thus, the trade off. But we can always “improvise” & make “do” with what we DO have & still have some form of intimacy with our partner.
Where there’s a will, there’s always a way!
All the best to you.

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Even if "things" are not functional down there, there are many ways to have fantastic "outercourse"! Just ask my wife, we're both very happy.

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@rosebookay

Low and benign side effects?????? My father had a major gastric bleed and died from it. It also causes low sodium in seniors which can be deadly. I’m glad you have had good results but it is hardly a drug of low and benign side effects. And….yes they can precipitate neuropathy particularly by raising blood glucose levels.

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So sorry to hear your father had a major gastric bleed and died from Zoloft.
How was that diagnosed and determined that Zoloft was the culprit?
My sodium levels have been perfect since starting Zoloft as well as my blood glucose levels - my Hg. A1C has always been in the normal range.
Everyone reacts differently from any class of medications...we all know that.
What does wonders for me can be a disaster for someone else. Very often it's trial & error to discover the medication that is an effective "fit".
I am simply giving you my opinion on this drug and how it affected me. A psychiatrist really pushed me to change my current anti-depressant to Zoloft. She worked with the geriatric population and felt this was a safe drug for us seniors.
For anyone who complains of burning feet/ankles, I will reiterate again...a neurology consult is in order and reasonable. Again, this is my recommendation.
My sincere condolences for the loss of your Dad.

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Can't tell if this discussion is current -? I'm a 71 year old woman, just started Auvelity after years on Wellbutrin finally got a psychiatrist who prescribed it. It's only been 6 days, but I felt it right away. It's amazing. I had been crying 2-3 times per day, not any more. I was feeling so low, not any more. My only complaint is daytime sleepiness. I've been taking a lot of caffeine to help myself deal with it! I'm taking 45- 105mg twice per day. I don't want to stop taking it but wow the drowsiness!

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@mikayla68

Can't tell if this discussion is current -? I'm a 71 year old woman, just started Auvelity after years on Wellbutrin finally got a psychiatrist who prescribed it. It's only been 6 days, but I felt it right away. It's amazing. I had been crying 2-3 times per day, not any more. I was feeling so low, not any more. My only complaint is daytime sleepiness. I've been taking a lot of caffeine to help myself deal with it! I'm taking 45- 105mg twice per day. I don't want to stop taking it but wow the drowsiness!

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Just a followup - Dr has switched me to 1 pill per day to be taken at night, so I'm sure I'll be less drowsy now.

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@briarrose

So sorry to hear your father had a major gastric bleed and died from Zoloft.
How was that diagnosed and determined that Zoloft was the culprit?
My sodium levels have been perfect since starting Zoloft as well as my blood glucose levels - my Hg. A1C has always been in the normal range.
Everyone reacts differently from any class of medications...we all know that.
What does wonders for me can be a disaster for someone else. Very often it's trial & error to discover the medication that is an effective "fit".
I am simply giving you my opinion on this drug and how it affected me. A psychiatrist really pushed me to change my current anti-depressant to Zoloft. She worked with the geriatric population and felt this was a safe drug for us seniors.
For anyone who complains of burning feet/ankles, I will reiterate again...a neurology consult is in order and reasonable. Again, this is my recommendation.
My sincere condolences for the loss of your Dad.

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I don;t remember how it was diagnosed as it was over 20 years ago. However, Sertraline has the highest incidence of GI bleeds of any of the SSRI’s. Look it up. Plus, they pulled him off cold turkey pre surgery to try to stop the bleeding so I’m sure they realized it was the culprit.

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@bnancy

Good question. I’ll be following this. I’m on cymbalta/duloxetine for past few years. It works pretty good. I’m very sensitive to meds too, but this one has been pretty much ok. Different dosages 20,30,40,60 at different points in time Good for pain issues, too
But, hard to wean off to try anything different so I’ll stay on it I guess.
I am 73 yr. Female. Been on all kinds of antidepressants over the years.

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I am weaning ,I’m down to 30 mg of Cymbalta. Did the 20 mg help with your pain sins? The noise in my head is what I’m afraid of in getting lower and lower or off of it. I’m 69 on cymbalta for many years. Highest was 180 mg then stayed on 120 mgs for yrs then 60 for years now. I pray I can do it down to 30 mgs for no noise yet. It’s like a banging with electric energy zapping in my brain. Depression n anxiety.

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