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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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My mother is 90 years old and suffers from mild to moderate

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My mother is 90 years old and suffers from mild to moderate dementia. About two weeks ago, she woke up with nasal congestion and thought she was dying. Even though she settled down, now every day she has panic attacks related to not being able to breathe and constantly says I'm dying or I'm dead. We took her to familiy MD a couple of days ago and he prescribed ativan 1mg twice a day. When we got her home she was in such a panic, we could not even get her to take a pill. We had to call an ambulance and take her to the hospital where they performed a number of tests and said everything physical was fine. The gave her an intrvenous sedative and in 15 minutes she was back to normal. They sent us home and suggested .5mg of Xanax time tealease twice a day. It's a little bit better, but tonight she started over the same theing. Any suggestions?
Submitted: 5 years ago.
Category: Mental Health
Expert:  MN Psychiatrist replied 5 years ago.
Hello, I am a psychiatrist.
I could help you best if knew if your mother had any other psychiatric history, including any past history of anxiety or panic. Also, aside from the Xanax, is she taking any other medications at all?
Customer: replied 5 years ago.
No, my mother never had any history of psychiatric episodes although she was always a worrier. She takes aricept, toprol xl lasix and synthroid as well for many years. Health is actually pretty good. She fell in 2007 and hip replacement surgery. She also is hard of hearing (hearing aid) and in the last year lost a significant amount of vision due to macular degeneration. She has always been a worker and lives with my father 91. Since starting the xanax, she is a little wobbly when she gets up in the morning, so somebody spends the night. Also, when she gets into a panic is it best to try to change the subject because when we say don't worry, you are fine, it seems to make it worse. Or do you jest let her contuinually rant I can't breathe, I'm dead, etc. BTW, when she dozes off, I can she she is breathing fine because her mouth is closed and she i sleeping fine.
Expert:  MN Psychiatrist replied 5 years ago.
For as miserable as it is, panic is very easily prevented most of the time, by prescribing an SSRI (serotonin) antidepressant, such as Zoloft, Prozac, Celexa, etc., that is taken on a daily basis.

This is often a better way to deal with it, because this way the panic episodes stop happening, rather than occurring and then everyone scrambling to calm her down. It's well worth discussing with her physician.
Does this make sense?
Customer: replied 5 years ago.
Is zoloft or other SRI well tolerated by those 90 years old? Also do you take the xanax until the zoloft starts to work?
Expert:  MN Psychiatrist replied 5 years ago.
Zoloft and other SSRIs can certainly be tolerated by people that age, though the doses must be reduced; while a young adult might well be started on 50mg of Zoloft or 20mg of Prozac, I would start a 90-year-old on something like 12.5mg of Zoloft or 5-10mg of Prozac.

The Xanax may be taken until the SSRI starts to work, and even after, if there is still some occasional panic; my big concern is that your mother not fall and break a bone from having her sense of balance affected by the Xanax.
Customer: replied 5 years ago.
Thank you. I am making an appointment to see a geriatric psychiatrist in the area. Hopefully he will prescribe something similar to what you suggested. In the meantime, I'll read up on them. We will watch her until we feel she is safe to alk on her own. Our doctor said that if she wasn't wobbly before the xanax, it is probably the cause, and hopefully will subside in 7-10 days. We'll watch her until then. Thanks again.
Expert:  MN Psychiatrist replied 5 years ago.
I'm glad I could be of help.
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