Helping Mom get off Prozac

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Now that I've just about tamed the benzo beast I've turned my attention to helping my 90 year old mother get off some of the meds she's been prescribed over the years. When my dad died three years ago her doctor decided she was depressed (duh) and recommended she start taking Prozac. Being in grief mode myself I went along with the recommendation, never once thinking of the long term effect this drug might have or how difficult it might be for her to get off it. I spoke with the nurse at the assisted living facility where my mom lives and she said she could start the process by consulting with the pharmacist who dispenses the medications there. She said Mom's doctor might not go along with a plan for withdrawal to which I replied "Then I'll find another doctor." Whether he agrees with the plan or not I'm almost certain that he will know absolutely nothing about withdrawing safely from Prozac.

I've read a few things about Prozac withdrawal, but there really isn't a whole lot out there about how to safely withdraw. Most "experts" say that because of its long half life (15 days) there aren't any significant withdrawal effects. Others say that a safe tapering schedule would be to reduce by anywhere from 5% to 20% every week. 20% a week seems way too fast so I'm inclined to think that 5% would be better. I don't want her to suffer needlessly and really want this to be as comfortable and gentle a process as possible for her. Any advice is greatly appreciated!

 

Thanks,

Lynne

[[el...]]

Hi Lynne, good to see you!

 

Well, don't let anyone tell you that you don't need to taper off any ssri! Brutal!

I don't know about prozac, but I've tapered off paxil, and lexapro. It's difficult to taper at the lower percents, unless of course you are starting from high doses. Or you could do a liquid titration, but I doubt the assisted living nurses would be willing to do that for her. Could she do it herself?

I was on about 15mg paxil and I tapered by 2.5mg every couple of weeks. I had flu-ish feelings and strange brain sensations if I moved my head too fast. They extended about month out from my finish. But I had insomnia for a long time after.

 

Anyway, good luck with your mom.

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Hi Eljay,

Some things never change; as usual you are one of the first to reply to my distress call  !

I'm not sure how the tapering would play out but the nurse was open to it. Mom can get liquid Prozac which would make the process easier. There's no way she could do it herself but I could possibly help as I live less than two miles from her. I was also thinking that I could have the local compounding pharmacy make up some appropriate doses for her. Thanks for validating what I suspected was true - that tapering from an ssri is the only way to go. I'll keep you posted...

 

Lynne 

[[Pa...]]

Hi lem,

 

I was just wondering why you feel your Mom should go off of the Prozac? 

 

Pam

[[el...]]

LIquid prozac is a great idea I didn't think of that. She could do it nice and slowly that way. 

[[...]]

Hi lem,

 

I was just wondering why you feel your Mom should go off of the Prozac? 

 

Pam

 

I don't believe she should have started taking Prozac in the first place. Her doctor prescribed it after my dad died because he thought she was depressed. She was grief stricken and lonely, which is understandable considering they were happily married for 60+ years. A year before my dad's death they relocated to be closer to my family and me, another adjustment she had just begun to ease into. All these traumatic life changes contributed negatively to her state of mind. However, I believe time would have been a better healer than Prozac.

I started researching all the medications she takes after reading the book "Our Daily Meds" and became concerned that she is overmedicated. Prozac is contraindicated for the elderly according to the Revised Beers Criteria, a publication that lists medications that are problematic when taken by elderly people.

Prozac may also interact with other meds she takes, most notably Aricept, a medication designed to slow the progression of dementia.

In addition, my mom is sleepy and tired all the time and is simply not very motivated to do much of anything. She used to be  upbeat, active, and interested in the world around her. I don't think her current behavior is because she's old or because she's still mourning the loss of my dad, at least not to the same degree she was - I think she's been drugged into a stupor and I intend to help her regain herself again.

Prozac is not the only med I think she needs to be rid of, it's just the first on the list.

 

Hope that answers your question...Lynne

[[el...]]

lynne,

 

what dose is she on?

[[...]]

lynne,

 

what dose is she on?

 

20mg/day - not terribly high but then any amount is too much as far as I'm concerned.

[[el...]]

lynne,

 

what dose is she on?

 

20mg/day - not terribly high but then any amount is too much as far as I'm concerned.

 

ok, not too bad, but you are right. Especially for a 90 year old, whos liver and kidney function is most likely not great.  But at least her taper will go easier than if she was on a high dose.

 

I was on 20mg paxil when I was first put on and I was practically catatonic. I dropped my dose and never took more than 10-15mg after that. And I was less than half her age. 

[[ha...]]

I recommend a book called "The Anti-depressant Solution" by Dr. Joseph Glenmullen. He also wrote "Prozac Backlash".  In the first, he is very specific about which anti-depressants and at what rate to taper.  Very important information for anyone on anti-depressants.  I haven't read your whole thread, only skimmed, but if your Mom is 90 years old, what quality of life issues compel you to consider taking her off the a/d?  Given that some withdrawal symptoms will like occur, despite the rate of taper.  Not in everyone, but in a lot of patients.  Just a thought.

[[an...]]

If you can get the liquid prozac in hand, you can use a small syringe (no needle needed) to measure out doses. 

 

I don't recall where I got mine but it it holds 1.0 ml and the markings are on the side for hundreths of a ml.  I had used it when I was taking liquid prozac long ago and now it gets used for other household tasks like dropping H2O2 into things. 

[[el...]]

If you can get the liquid prozac in hand, you can use a small syringe (no needle needed) to measure out doses.   

 

I don't recall where I got mine but it it holds 1.0 ml and the markings are on the side for hundreths of a ml.  I had used it when I was taking liquid prozac long ago and now it gets used for other household tasks like dropping H2O2 into things. 

 

You can get them at the pharmacy otc, I think, as long as it's just a syringe body and no needle. Actually, her skilled nursing facility has them, I'm sure.   

I use them a lot for measuring out fish meds for my goldfish, and also cat meds, etc. Anyway, I ordered 100 of them online from canada, lol! 3cc syringes.

[[Pa...]]

Hi lem,

 

I was just wondering why you feel your Mom should go off of the Prozac? 

 

Pam

 

I don't believe she should have started taking Prozac in the first place. Her doctor prescribed it after my dad died because he thought she was depressed. She was grief stricken and lonely, which is understandable considering they were happily married for 60+ years. A year before my dad's death they relocated to be closer to my family and me, another adjustment she had just begun to ease into. All these traumatic life changes contributed negatively to her state of mind. However, I believe time would have been a better healer than Prozac.

I started researching all the medications she takes after reading the book "Our Daily Meds" and became concerned that she is overmedicated. Prozac is contraindicated for the elderly according to the Revised Beers Criteria, a publication that lists medications that are problematic when taken by elderly people.

Prozac may also interact with other meds she takes, most notably Aricept, a medication designed to slow the progression of dementia.

In addition, my mom is sleepy and tired all the time and is simply not very motivated to do much of anything. She used to be  upbeat, active, and interested in the world around her. I don't think her current behavior is because she's old or because she's still mourning the loss of my dad, at least not to the same degree she was - I think she's been drugged into a stupor and I intend to help her regain herself again.

Prozac is not the only med I think she needs to be rid of, it's just the first on the list.

 

Hope that answers your question...Lynne

 

Hi Lem,

 

Wow, you've done an incredible amount of research.  Your understanding of your mother's needs and your commitment to her well being is admirable.  You're a true champion.  Thanks for answering my question, I wondered because of an experience I had with my Mom before she died. 

 

Pam

[[an...]]

curved tip syringe is good for cats to squirt stuff high up back in roof of mouth ----- but not all have markings on them

 

many pharmacies will sell syringes without needle - all depends on state laws - we got some at Farm Supply in IL until the state realized they were being sold there and curtailed it  

 

baby medicine droppers or syringes will work too - here Walmart gave me some for my cats when I asked (of course I didn't tell them it was for cats not a baby)  

[[...]]

I recommend a book called "The Anti-depressant Solution" by Dr. Joseph Glenmullen. He also wrote "Prozac Backlash".  In the first, he is very specific about which anti-depressants and at what rate to taper.  Very important information for anyone on anti-depressants.  I haven't read your whole thread, only skimmed, but if your Mom is 90 years old, what quality of life issues compel you to consider taking her off the a/d?  Given that some withdrawal symptoms will like occur, despite the rate of taper.  Not in everyone, but in a lot of patients.  Just a thought.

 

Thanks for the book recommendation, Hawkeye. I ordered a used copy from Amazon yesterday.

My mom's quality of life is poor; she is always sleepy and even when she says she wants to do this or that activity can't muster the energy to actual do it. She has many other symptoms of overmedication that I'd rather not go into. Let's just say I'm completely cynical when it comes to prescription drugs and Big Pharma and that I really believe her life will be better after she's off the worst of the meds.

 

Lynne

[[...]]

 

Hi Lem,

 

Wow, you've done an incredible amount of research.  Your understanding of your mother's needs and your commitment to her well being is admirable.  You're a true champion.  Thanks for answering my question, I wondered because of an experience I had with my Mom before she died. 

 

Pam

 

Thanks Pam!

[[sp...]]

Thought Id let you know my drug psychologist told me that with 20mg prozac the safe way to come off is to drop one 20mg dose once a week for 3-4 weeks, then 2 doses the next 3-4 weeks, then 3 doses the next 3-4 weeks and so on until no doses!  He is very experienced in drug withdrawl and takes people off these meds for a living.  Thought this might help as hard to use liquid prozac as need such large amounts and chemists not keen to dispense it.

Hope it help

spring

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Thank you, Spring! How did the doc spread out the dropped doses? I'll assume that the second dropped dose was three or four days after the first (say Monday and Thursday for instance), then the third dropped dose would be Monday, Wednesday and Friday, and so on until done. This may be too complicated for the med aides at Mom's assisted living facility to deal with but I appreciate learning about another option.

 

Lynne

[[sp...]]

Lynne

You are correct in terms of spreading out dosage.  My mum runs a resthome and suggested you draw up a schedule for the home for say a month (one week to a page say) and give it to them with a signature for each dose.  This might make it easier for them and give you peace of mind

best of luck to you

spring

[[...]]

Lynne

You are correct in terms of spreading out dosage.  My mum runs a resthome and suggested you draw up a schedule for the home for say a month (one week to a page say) and give it to them with a signature for each dose.  This might make it easier for them and give you peace of mind

best of luck to you

spring

 

Thanks so much for all your helpful suggestions. My plan is to take a tentative schedule to Mom's doctor (hoping to get the new, young PA who may be more compliant  ) and work something out there. They will then write an order for the nurse at the ALF. Wish me luck!

 

Lynne

[[pa...]]

Good luck lem!! Your a good daughter to do this for your mother! I hope I get that lucky!

 

Amanda 

[[...]]

I took mom to the doc today and he (actually the PA) agreed to help her taper from Prozac. However, his taper plan would have her go from 20mg to 10mg for a week, then go completely off - way too fast as far as I'm concerned. I said I wasn't comfortable with that so we'll be working on a plan that I can live with. I don't understand the rapid taper - even if she did okay with it what's wrong with going slower? He just kept saying that because if its long half life Prozac is easy to get off of - I kept replying that I'd prefer a slower taper and around and around we went. He underestimates my determination, that's for sure. We agreed that she would go off a different drug first (something that doesn't require tapering), check back in a month, then start the Prozac taper.

 

A side note: I felt intimidated the last time I went with my mom to this PA and figured out that it was partially because I was sitting in a chair that was lower than his. This time I decided to stand, which made me "taller" and feel more powerful - hehe.

 

Lynne 

[[Be...]]

I took mom to the doc today and he (actually the PA) agreed to help her taper from Prozac. However, his taper plan would have her go from 20mg to 10mg for a week, then go completely off - way too fast as far as I'm concerned. I said I wasn't comfortable with that so we'll be working on a plan that I can live with. I don't understand the rapid taper - even if she did okay with it what's wrong with going slower? He just kept saying that because if its long half life Prozac is easy to get off of - I kept replying that I'd prefer a slower taper and around and around we went. He underestimates my determination, that's for sure. We agreed that she would go off a different drug first (something that doesn't require tapering), check back in a month, then start the Prozac taper.

 

A side note: I felt intimidated the last time I went with my mom to this PA and figured out that it was partially because I was sitting in a chair that was lower than his. This time I decided to stand, which made me "taller" and feel more powerful - hehe.

 

Lynne 

 

That is absolutely wonderful, Lynne.  A lot of people in positions of power purposely put their "guests" in a lower chair for just the reason you mentioned.  I don't know if I would have thought of such a perfect solution.  WTG, Lynne! 

[[...]]

A little over a month ago my mom went from 20 mg Prozac to 10 mg. The PA agreed that a month at this dose would be fine, we'd see how she felt then re-assess. She seemed okay the entire time so we agreed at her appointment on Wednesday to have her discontinue the drug completely. I feel okay about this decision after doing some pretty thorough research; if she feels too bad she can always reinstate I suppose. Too early to tell what effect the jump off may or may not have - with any luck she won't notice a thing!

 

Lynne 

[[kl...]]

i read on the intro to this site that "we are not anti-doctor" i really hope that people on this site don't "play doctor"!!!!