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Tuesday, April 28, 2009

Lithium Treatment for Depression in the Elderly

QUESTION: When my father died, my mother went all to pieces.
After 55 years of being together we thought her depression was understandable, but now the doctor who takes care of all the people at her home wants to put her on lithium as a treatment for depression.
Isn't that kind of strong medicine for a natural reaction? With all the stories about too much medicine for older people, we thought your advice would be most helpful.

ANSWER: Your obvious concern and anxiety, plus the circumstances as you describe them, make a "second opinion" from another physician a wise and appropriate course of action.
This very potent drug can be useful in treating depression in the elderly, but it should be used only for psychiatric conditions that cause depression.
You are right when you say your mother's reaction is understandable after the loss of her husband of many years, and is probably normal, as depression is often a big part of grieving.
The elderly often become depressed because of loneliness, a reaction to loss, or a negative reaction to medications. There are, however, other types of antidepressants besides lithium that can be used effectively at these times. If your mother is indeed found to be suffering from a manic-depressive illness, then lithium can be helpful, as it is being used successfully in some elderly patients.
She should get regular checkups and have follow-up lab work done frequently for the lithium to be used safely. Lithium should not be given to patients with severe kidney or cardiovascular disease, or be taken with diuretics, as the drug could become toxic under these circumstances.
You can see that, when obtaining another opinion, it is most important that you present all the history about your mother, including a list of medications she may be taking presently.
And it is most important in situations such as this that you continue to monitor the progress of your mother.
Your frequent visits may be more therapeutic than the medications, and you can personally verify her mental state more accurately.


The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.