Winnie’s Story
July 7 2024 | Last Updated: July 7 2024
Reversal of Memory Problems in 12 months
Depression, Grief, Paroxetine, Sleep
Winnie had suffered a great loss. Her husband had passed away unexpectedly 3 months ago.
She had a history of depression after her second child, and had already been on an antidepressant called paroxetine for many years.
Her oldest son, who lived with her along with his family, had noticed Winnie was suddenly up all night pacing, unable to sleep, short-tempered and irritable, forgetful, and barely eating.
Even before the significant change after her husband passed, they had noticed Winnie was getting more forgetful over the last few years.
Her MoCA was 20/30 (low for her age and educational background).
Winnie’s geriatrician helped her come up with the following plan:
1) Start a different type of antidepressant called Mirtazapine for sleep and low mood
2) Grief counselling
3) Do something active 3 times a week
What Happened Next?
The next time Winnie saw her geriatrician, she was doing much better.
She reported that she hadn’t actually enjoyed the grief counselling very much, but she had found the Mirtazapine quite helpful for her sleep.
Time was indeed passing and she was coming to terms with her husband’s passing.
The summer weather was also helping, and she had started gardening 3 times a week.
Her geriatrician suggested that she:
1) Continue Mirtazapine and exercise
2) Come back and see them in 3 months
… what happened next?
It had now been 9 months since Winnie’s husband had passed away.
Winnie was feeling closer to her old self again. She was no longer up at night, her appetite had gone back to normal, and she felt like she could concentrate again.
She did memory testing again and her MoCA was now 22/30 (improved, but still low).
Given how well she was doing, her geriatrician suggested she:
1) Taper off her Paroxetine, which can cause memory problems.
What happened in the end?
It took Winnie and her geriatrician several months to make very small changes to the dosing of her paroxetine to avoid withdrawal symptoms, but eventually, she was off the medication.
Winnie’s MoCA was now 25/30 (within normal range)
Her mood had also completely recovered, and she was sleeping like usual again.
She was still forgetful from time to time, but both she and her family had noticed a significant improvement, even compared to how her memory was 2-3 years ago.
Her geriatrician suggested she:
1) Decrease her Mirtazapine to 7.5mg and after 4 weeks, stop it entirely.
By 10 months, Winnie was off her medications and living a fulfilling life again.
What does Winnie’s story teach us?
Winnie’s story shows us how strong emotions like depression and grief can impact our memories. Winnie’s memory problems were being caused by:
Grief and depression
Lack of sleep
Lack of physical activity
Medication (paroxetine)
Winnie’s story also shows us that there is a time and a place for medications. Once her emotional health had improved, Winnie was able to come off both the Paroxetine and Mirtazapine.
Always reassess whether you need your medications every few years, especially if you’ve been able to solve your problems with lifestyle.
Well done to Winnie on overcoming a difficult time in her life.
Disclaimer: The stories shared on this website are composites of several clinical cases, designed to protect individuals' privacy. They are intended for educational and informational purposes only and should not be construed as medical advice or a reflection of any specific person. Any resemblance to actual persons, living or deceased, is purely coincidental.