What could cause anxiety and agitation if a patient stops taking antipsychotic medication?

Question

Hi doctor,

My mother is 74 years old. Two years back, she was diagnosed with depression and prescribed Locert 50 (Sertraline) and Lepose 1 (Lorazepam) for six months. After that, she was completely recovered. For the past few months, she has started taking Lepose 1 whenever she feels slight anxiety. The past few days, as soon as she stopped taking Lepose, she has started having anxiety and agitation (strong bouts with the urge to make hand movements).

Could you please suggest any solution?

Is she getting addicted, and these are withdrawal symptoms? Please suggest remedial measures.

Thank you.

Answer 1

Hii,

I read your query and understand your concern.

Lorazepam is a rapidly addicting drug, which means it is very likely that your mother is experiencing withdrawal symptoms. It is not a good choice for an elderly person to take as and when required. Since she took it frequently for a month, sudden stoppage would cause withdrawal symptoms like tremors and anxiety. Since she has been feeling a recurrence of anxiety symptoms for the last month, it could also indicate a possibility of another bout of depressive episodes happening in a while. You can try to slowly reduce the dose of Lorazepam to half, continue it for a couple of days, reduce it to half again for another two days, and stop. Observe her for a week. If you feel she has other persistent symptoms of depression like the past episode, you can restart Sertraline (Sertraline Hydrochloride) 25 milligrams and increase it to 50 milligrams after a week.

Consult with her doctor and take the medicine with their consent.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Yes, slowly stop that medicine and reduce the current dosage to half. I guess your mother is taking 0.5 milligrams tablet once per night, so make it into 0.25 milligrams per night for a few more days, then if possible, reduce further and stop. It is a pretty addictive drug, so she might experience some withdrawal symptoms, which will resolve. Be mindful of another episode of depression in case symptoms persist. Consult with a doctor and take the medicine with their consent.

Thank you.