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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@walk4life

@briarrose , i have been taking Sertraline for almost 30 years. At times i have been able to wean myself off for a few months at a time. I started at the low dose , but have been taking 150 mg for the last 10 years. It has been so long since i started taking the medicine, i don’t remember what ssri i tried before.

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Hi walk4life,

Wow, 30 years on Zoloft! I thought I was a record when I was on mirtazapine for 22 years 🙂
Don't know your age but is 150 mg. high? My 67 y.o. husband is on 50 mg. for 7 years now with never a side effect (lucky him) and it helped him immediately for awful anxiety.
It's still working and he probably will never come off it. Right now he has no intention of.
But I suppose the bottom line is if 150 mg. of Zoloft is working for you and giving you mental health well being why play around with it? Unless it's not effective anymore or you wish to change your medication or even stay off of it? Don't know your circumstances but hope all is well in your particular situation.

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Yes, i have tried to wean off at times over the years, but i find after a few weeks without it the depression creeps back in. Very few people even in my family know that i suffer from depression. 150 mg is at the high end of dosage. Good for your husband if the 50 mg works for him.

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@walk4life

Yes, i have tried to wean off at times over the years, but i find after a few weeks without it the depression creeps back in. Very few people even in my family know that i suffer from depression. 150 mg is at the high end of dosage. Good for your husband if the 50 mg works for him.

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Hi walk4life,
Yes, my husband is fortunate with Zoloft at 50 mg. I just spoke with my psychiatric nurse practitioner and he suggested I stop Paxil 10 mg. completely now (have been taking only 5 mg. for a week) and start Zoloft 25 mg. tomorrow. I even wondered out loud if I should be off all SSRI/SNRIs & just continue with my low dose Xanax and Klonopin for my severe panic attacks/PTSD/dysthemia but he was against this idea. At 68 y.o. I am finding myself now so sensitive to all medications - for my physical as well as my mental health. I suppose part of the aging process? Ugh! And I hear you about few people knowing you suffer from depression. I am in the same boat. It's unfortunate, isn't it? But the stigma of mental illness is alive & well even in 2023. And most folks are completely clueless when it comes to the illness of depression. That old adage "just pull yourself up by your boot straps" continues to be so common. And family members can be the harshest critics. They don't "get it", think you are "acting out" or believe "you have everything going for you! how can you be depressed?" All of which just adds to one's depression! Strong, loving emotional support in coping with the demons of mental illness is vital to helping one survive it - and live their best possible life despite being a member of the walking wounded. But so many of us find that is lacking in our lives...so we suffer in silence - thinking "why bother discussing it with people who don't understand it?" A true shame - everyone loses.
You are not alone, hang in there!

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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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Hi bnancy,
I wanted to update you. I began cutting my Paxil 10 mg. in 1/2 this week in anticipation of coming off of it. I spoke with my psychiatric nurse practitioner this morning. I will be starting Zoloft 25 mg. tomorrow and completely stopping Paxil. I can not take Cymbalta. I have had the GeneSight Psychotropic testing done and I have a significant gene-drug interaction with this drug. Zoloft is "use as directed" for me. I would recommend anyone who is struggling with finding the best "psychiatric" medication for themselves to speak with their providers about having this test (it's a cheek swab & sent to their lab). I am on medicare and it cost me nothing...your insurance might not cover it completely but I felt it was worth it even if it cost me money since I am so "difficult" to treat now, at 68 y.o.
Glad to hear your medication is working pretty good for you. Continued good luck!

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@briarrose

Hi walk4life,
Yes, my husband is fortunate with Zoloft at 50 mg. I just spoke with my psychiatric nurse practitioner and he suggested I stop Paxil 10 mg. completely now (have been taking only 5 mg. for a week) and start Zoloft 25 mg. tomorrow. I even wondered out loud if I should be off all SSRI/SNRIs & just continue with my low dose Xanax and Klonopin for my severe panic attacks/PTSD/dysthemia but he was against this idea. At 68 y.o. I am finding myself now so sensitive to all medications - for my physical as well as my mental health. I suppose part of the aging process? Ugh! And I hear you about few people knowing you suffer from depression. I am in the same boat. It's unfortunate, isn't it? But the stigma of mental illness is alive & well even in 2023. And most folks are completely clueless when it comes to the illness of depression. That old adage "just pull yourself up by your boot straps" continues to be so common. And family members can be the harshest critics. They don't "get it", think you are "acting out" or believe "you have everything going for you! how can you be depressed?" All of which just adds to one's depression! Strong, loving emotional support in coping with the demons of mental illness is vital to helping one survive it - and live their best possible life despite being a member of the walking wounded. But so many of us find that is lacking in our lives...so we suffer in silence - thinking "why bother discussing it with people who don't understand it?" A true shame - everyone loses.
You are not alone, hang in there!

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@briarrose - yes anyone looking at my life would say that i have nothing to be depressed about. I think people who have never experienced depression don’t understand that it is not something you can just snap out of.

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@walk4life

@briarrose - yes anyone looking at my life would say that i have nothing to be depressed about. I think people who have never experienced depression don’t understand that it is not something you can just snap out of.

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So very true! People looking at my life would say the same thing.
I am sure there are so many people suffering with depression or even anxiety (the most common mental health issues in the world) who keep it quiet.
Why risk being hurt, judged, shamed or marginalized?
How I wish it wasn't this way...we accept those suffering with physical ailments - why is the health of the mind any different?
It's like that old saying...don't judge me until you walked a mile in my shoes.
Continue to hang in and hang on. You are not alone.

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At 74 I just started Auvelity. I have to admit I have a newfound purpose in getting things done and this is the first time in years. Still having anxiety but this med is only saying it works for depression. However I am having a hell of a time eating, I have no interest in food Until later in the day. I think this would be a huge nutritional problem for some and perhaps is for me. I have only been on this for three months. But I finally got my house tiled I planted plants outside and seem to care about life more . I swear my parents made this retirement life look a lot easier than it is. Good luck.

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Haven't heard of Auvelity, it must be fairly new and did look it up. Not surprised you find yourself with purpose in getting things done as one of its main components is a stimulant. Do keep an eye on your blood pressure if this is an issue for you as one of its side effects is possible increased blood pressure. But as it is with all medications, everyone's body reacts differently and what could be an intolerable side effect for one - doesn't even phase another. I was on Paxil 10 mg. for 8 weeks and had to stop due to side effects - one of which was a complete lack of hunger. I completely lost my appetite almost immediately when I started it - yet didn't lose any weight! That was only one unacceptable side effect for me, stopped it and just started Zoloft 25 mg. daily. We'll see how this goes in terms of side effects and efficacy. At 68 I am finding all new medications can now affect me in a negative way...I never had this problem when younger. At 74 you do must watch your nutritional intake. Boost, Ensure & other protein/supplement drinks might be the way for you go until you are able to eat a full meal. And, of course, at the very least a multi-vitamin daily. So glad to hear you care about life more! I more than understand that & you are too young not to! Self care activities - yoga, meditation, walking, inspirational readings, guided imagery, relaxation tapes, music, spa treatments, nature, healthy social connects - might help to decrease your anxiety in addition to medication. And, believe me, I hear you loud and clear about the "reality" of retirement! You are Right On! Since mine, I can't begin to list the challenges - physical, mental, emotional, social, spiritual (the list goes on 🙂 I had to contend with and still do! Our parents did make it look easy...maybe because life at this stage for them was EASY! Our world in 2023 so much harder in so many ways...continued Good Luck to you as well!

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