SSRI Sleep disruption and the elderly

BlackSpinner · Post by **BlackSpinner** » Mon Oct 17, 2016 9:47 am

http://www.medscape.com/viewarticle/870286

Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), can significantly disrupt sleep architecture in elderly patients and may contribute to early signs of neurodegeneration that can progress to dementia, new research shows.

"We take into account other side effects of antidepressants, including weight gain and sexual side effects, but we are less concerned about sleep, especially when we use the SSRIs," Muhammad Tahir, MD, psychiatry resident, SUNY Upstate Medical University, Syracuse, New York, told Medscape Medical News.

"But the SSRIs increase sleep latency in the elderly and decrease REM [rapid eye movement] sleep duration and are also associated with REM sleep behavioral disorders, including nightmares," he added.

"So our literature review suggests that we should be careful about using SSRIs in the elderly population and not underestimate the effectiveness of psychotherapy and other holistic care approaches for the elderly," Dr Tahir said.

chunkyfrog · Post by **chunkyfrog** » Mon Oct 17, 2016 10:12 am

Some drugs representative of this class:

Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil, Pexeva)
Sertraline (Zoloft)
Vilazodone (Viibryd)

(Edit) Kind of scary when you see how many of the elderly are obviously drugged in a nursing home.
The meds that keep them quiet are also making them WORSE!

BlackSpinner · Post by **BlackSpinner** » Mon Oct 17, 2016 10:17 am

Thanks Froggy!

I should have thought of that.

JimW159 · Post by **JimW159** » Mon Oct 17, 2016 10:21 am

BlackSpinner wrote:http://www.medscape.com/viewarticle/870286

"But the SSRIs increase sleep latency in the elderly and decrease REM [rapid eye movement] sleep duration and are also associated with REM sleep behavioral disorders, including nightmares," he added.
"So our literature review suggests that we should be careful about using SSRIs in the elderly population and not underestimate the effectiveness of psychotherapy and other holistic care approaches for the elderly," Dr Tahir said.

Oh, joy! One more thing to look forward to.

Grace~~~ · Post by **Grace~~~** » Mon Oct 17, 2016 10:31 am

I wonder what age is considered 'elderly'?

When I was diagnosed three years ago (with 'the big issue' not apnea) I was given prescriptions of just about everything on that list. I still haven't thrown away the untouched bottles.

I heard unmelodic drums coming for me. Was in terror. Shock. Screaming out of control lost emotions.
No doubt the worst of the worst reactions most had ever seen ... I did NOT believe it was true.
I did not have any family or caregivers in place for such an event. I had many sorts of medical professionals both reason and even beg me to take those pills.

I wondered if they were just going to inject me with those drugs with the chemo and steroids?

...maybe they did?

The answer for *me* began with The Ladder of Divine Ascent. St John Chrysostom.
Perhaps you need to be on the bleeding edge of the razor looking in to eternity to get it?

...but I am eternally grateful I never took those drugs.

49er · Post by **49er** » Mon Oct 17, 2016 10:51 am

I am a 61 year old person who started taking psych meds which included SSRIS when I was 40. I was on them for fifteen years, which included a nearly 4 year taper off of them.

I honestly feel being on these meds contributed to my sleep cycle being very fragile. Sadly, my experience is not unique.

So while it is good that they are recognizing that SSRIs should be cautiously prescribed in the elderly, this caution needs to extend to all age groups in my opinion.

Many of these drugs are prescribed by PCPs for life issues when instead they should be referring these patients for psychotherapy or referring them to self help groups. But I guess they are so rushed for time, that it is easier to prescribe a pill.

Thanks for posting the link BS.

49er

49er · Post by **49er** » Mon Oct 17, 2016 10:53 am

chunkyfrog wrote:Some drugs representative of this class:

Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil, Pexeva)
Sertraline (Zoloft)
Vilazodone (Viibryd)

(Edit) Kind of scary when you see how many of the elderly are obviously drugged in a nursing home.
The meds that keep them quiet are also making them WORSE!

Unfortunately, they are drugged with antipsychotics which have usually have worse side effects than SSRIs.

49er

BlackSpinner · Post by **BlackSpinner** » Mon Oct 17, 2016 11:44 am

49er wrote:
Many of these drugs are prescribed by PCPs for life issues when instead they should be referring these patients for psychotherapy or referring them to self help groups. But I guess they are so rushed for time, that it is easier to prescribe a pill.

Thanks for posting the link BS.

49er

Yes. There should be a rule about that. Only one cycle of those meds allowed and a referral to a specialist.

My youngest fell into that trap too. She got her self off them with difficulty and is now very wary of taking these kinds of drugs without a specialist and other therapy.

chunkyfrog · Post by **chunkyfrog** » Mon Oct 17, 2016 11:48 am

Another reason why pharma is a good item in your investment portfolio.

Sir NoddinOff · Post by **Sir NoddinOff** » Mon Oct 17, 2016 11:51 am

I wonder if the newer SNRI's have that in common with the older SSRI meds? Tricyclics?

BTW, Medscape is asking me to log in.

Lucyhere · Post by **Lucyhere** » Mon Oct 17, 2016 12:10 pm

49er wrote:Many of these drugs are prescribed by PCPs for life issues when instead they should be referring these patients for psychotherapy or referring them to self help groups.

49er

Absolutely. However, I would add that in some cases psychotherapy, self help groups and medication seems to work better for some people. I'm currently in a group with six women and three men. Two people in the group were in bad shape for various reasons, and their doctors suggested meds (not sure which ones). After about six weeks the turn around was remarkable. One person registered for a college class at a nearby college after not being able to get out of bed in the morning, and the other person said his day to day living was so much easier and he was starting to enjoy the small things in life once again. SSRI's should be a last resort when everything else has failed. However, one size doesn't always fit all.

Julie · Post by **Julie** » Mon Oct 17, 2016 12:12 pm

Anything that even potentially changes your brain should be very, very carefully weighed re using at all, or if planned to use only short term, then stick to that plan and don't keep using.

chunkyfrog · Post by **chunkyfrog** » Mon Oct 17, 2016 7:47 pm

Bumping this very important thread.

SSRI Sleep disruption and the elderly

SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly

Re: SSRI Sleep disruption and the elderly