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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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Is it safe to give a 93 year old woman (my Mom) 15 mg

Resolved Question:

Is it safe to give a 93 year old woman (my Mom) 15 mg Remeron for insomnia (for 3 weeks now), and then also to start her on 25 mg Zoloft for depression (which can cause insomnia)? Since moving into a nursing home, she is suffering from anxiety and depression. I'm concerned about mixing antidepressants, without a psychiatrist involved, monitoring progress/problems.

Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Vikas replied 5 years ago.

Has someone (Psychiatrist / GP) prescribed her these two medicines Remreon 15 mg and Zoloft 25 mg?


Customer: replied 5 years ago.
She is in a Nursing home. I'm in WA State and she is in WI State. My younger sister and niece are in the area where she is. They have medical staff, but I do not at this moment know what they are. I doubt that it is a psychiatrist (my deceased brother was one, I have a law degree and engineering background, but I learn). It may be a GP or nurse practicianer.
Expert:  Dr. Vikas replied 5 years ago.
Thanks for your reply.

I will not be able to comment about the safety of these two medicines in your mother's case as I am not aware of her current health status but I can give you a general answer.

Zoloft (Sertraline) is considered to be an activating antidepressant and as you mentioned correctly, it may cause insomnia in some patients (not all, some even report sedation), we usually tell our patients to take it in morning. Sertraline 25 mg is a low dose and it is a good idea to start with the low dose in elderly patients. Sertraline when added to Mirtazapine will augment the antidepressant and antianxiety effect of Mirtazapine.

Remeron (Mirtazapine) is a very sedating antidepressant and is specially useful in patients complaining of Insomnia. Your mother is 93 years old and Mirtazapine could be very sedative for her and this should be kept in mind while giving her this medicine.

We frequently use both Mirtazapine and Sertraline in combination in some of our patients who complain of Insomnia so as such, this is a very good combination.

I hope this helps.

Best wishes,


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