Seeking info on 75yo mom's anxiety/depression

[dotterly]

My 75 year old mother fell and hit her head about 7 months ago. She was evaluated the same night with an MRI and they said she was okay. She's had a few minor memory lapses since then, but about a month ago she started to have severe anxiety attacks and depression.

The other day she had a flu shot, and later in the day she was saying she felt terrible and like she couldn't breathe. I was worried she might be allergic to the flu shot, so I took her to emergency. The emergency doctor said it was anxiety and gave her a small supply of Ativan. She's seeing her regular doctor tomorrow, hoping for a referral to a neurologist. In the meantime, she ran out of Ativan. So yesterday my dad took her to a walk-in clinic and she was given another small supply of Ativan and a prescription for Prozac. She hasn't taken any of the Prozac yet - I thought it was better that she wait until she sees her regular internist, and she and my dad agreed.

I've been reading about this whole set of symptoms, and learned about something called Post Concussion Syndrome. It sounds very much like she's having that. But at her age, what are her chances for recovery? Should she get evaluated by a neurologist to make sure there isn't a worse brain injury than we think? Assuming she has to wait for that, is it safe for her to take the Ativan and/or Prozac in the meantime?

The Ativan is 1mg and the Prozac is 10mg. I understand these are fairly low doses, but I also believe they are both pretty powerful, so I wanted some guidance about what to tell her. Thanks for listening.

[CJ_]

Anxiety in older woman is so common its not funny, my Grandmother is almost 90!!! And she still takes Anti-Depressants but the thing is we had her off them and she was doing so much better and lively and what not but when she gets on them its all down hill, yelling and moody!

The medications should be fine for her health [Small dose] but it just might affect or moods and bring her Anxiety up.

[Paxiled]

These shouldn't be dosed by an internist but by a psychiatrist that specializes in older patients.  They must have smaller doses than younger people, and must be monitored closely because the meds can make them very confused and make it difficult for them to communicate what they're feeling.  So stay on top of it.  Doctors also have a tendency to take older people off meds precipitously and don't consider withdrawal.  Now, that shouldn't be a problem with Prozac, but as CJ said, it can be stimulating to some people, so be careful, but it is true with the Ativan.  And to have post concussion syndrome, you have to first have a concussion.  Be careful out there!

[dotterly]

Yeah, I'm not sure she actually had a "concussion" when she fell - I don't think they diagnosed her with that, because she didn't lose consciousness, etc. But one of the things I've read in the last few days is that with older people, the whole syndrome is actually more likely when they didn't lose consciousness. Weird.

I appreciate your advice about watching her closely. I plan to, and my dad is on top of it too (although he has his own issues, he is still pretty sharp). She's taken the Ativan fairly sporadically, so I'm not too worried about that. But I wasn't happy with the internist (even though he's a good doctor and I know him from other experiences with me, my son, etc. at the same clinic) he told her she should take Prozac instead of Ativan because it's "better". Now that sounds fairly generalizing and it doesn't seem logical, since they're completely different medications.

Really hoping for a neurological consult! They have to get referred for it, per her health insurance, by an internist.