Should we change the medication my mother is taking for depression and Alzheimer's?

1 answer | Last updated: Oct 12, 2016
Rendezvous 04 asked...

My mother has been on Citalopram 20mg twice daily for 10 years. Her old doctor gave it to her after my Dad passed. She said it would help with the sadness and mild anxiety. After reading a recent article on depression and Alzheimer's, I wonder if my mother needs something else. I have told her doctor that I think the medication doesn't help and she said let's keep it for now. Lately, my mother's aggression gets her so worked up that nothing I do helps. I'm afraid she is headed for another stroke. She has had two already and bounced back but more slowly from the last one. For some reason, they would not give her therapy after the second stroke. A helper and I did the best we could and she has regained some strength but still can not stand on her own. She is always afraid of falling. What can I do? It's taking its' toll on both of us. Thank You in advance.

Expert Answers

Ladislav Volicer, M.D., Ph.D., is recognized as an international expert on advanced dementia care. He is a courtesy full professor at the School of Aging Studies, University of South Florida, Tampa, and visiting professor at the Third Medical Faculty, Charles University, Prague, Czech Republic. Twenty-five years ago, he established one of the first dementia special care units.

I do not know which article did you read, but Citalopram is a medication recommended for treatment of depression in individuals with dementia. The problem may be that the dose is not sufficient. Some people develop tolerance to the effect of antidepressants and the dose has to be increased to maintain the effect. If that is not effective, it is possible to potentiate the antidepressant effect with aripiprazol (Abilify). The recovery from a stroke may not be possible and your mother may always need a help from others when she is standing up. Her "aggression" is caused by a lack of understanding of the caregiver's intentions and she may be just protecting herself from unwanted attention. Try not to force her to accept care, provide the care some other time or some other way (e.g., bed bath with a wet towel instead of shower or tub bath).