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Auditory hallucinations, psychosis. Not improving with zoloft. Treatment options?

My 71-year-old mother has been diagnosed with late onset psychosis . She has constant, frightening, auditory hallucinations that have been going on for a year. She had an MRI that came back as normal. She has had recurrent urinary tract infections that have been treated with antibiotics . She is on Zoloft and an anti-psychotic and her mental state is not improving. I don t know what to do for her. Each step we ve taken seems to lead to a dead end. Any suggestions on a new line of approach in detecting the cause and treatment? Any response is appreciated. Thank you.
Asked On : Mon, 25 Feb 2013
Answers:  2 Views:  106
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Psychiatrist 's  Response

welcome to health care magic

There could be various causes of late onset psychosis-
1) Organic brain injury/trauma/delirium (But visual hallucinations are prominent in that case)
2) Dementia
3) Depression
4) Schizophrenia (very rare in this age)

Zoloft contains sertraline which is an antidepressant.

In old age one has to give the dosages somewhat lesser than the adult dosages due to less efficient metabolism. But in any case, adequate dosage for adequate duration is required. I advise you to discuss all this in detail with the treating doctor for detailed assessment of causes of failure of the treatment. Incresed dosage or changing of medicines is probably required.

Hope it helps
Good Luck

Dr. Gourav Monga
Consultant Psychiatrist
Answered: Mon, 25 Feb 2013
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Psychiatrist Dr. Sundar Gnanavel's  Response
Thanks for your query. Late onset psychosis is difficult to treat considering the sensitivty to anti psychotics at extreme s of age. I would suggest a screening for dementia as it may present similar to late onset psychosis. We have a variety of antipsychotics for treatment including clozapine for resistant cases. Hence I would suggest discussion of non response to medication with your psychiatrist so that suitable alternative can be identified. Hope you found the information useful.
Dr Sundar
Answered: Wed, 27 Feb 2013
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