My Mom, 90, stages 6-7 of AD, has been in a nursing home for about 6 month's now, and her mood is definitely deteriorating. She has been on Effexor, and previously Zoloft, for several years. Lately her mood is getting darker, she hates being in the NH, knows she's not at home, but has no idea as to why. She talks more and more about wanting to be dead, I don't want to be like this, I don't want to be here, how can you do this to me, you don't want me around..... on and on.
Worse in the evenings, according to the NH staff, but is creeping into most of the day, she has had a couple days where she is crying and very agitated, (also takes Ativan daily now)and on some days she is in an o.k. mood.
Is this just expected, or have people found ways to adjust meds to stop this depressed cycle? Antidepressants have worked very well in past to bring her out of depressive states, but we are having trouble with Dr. in trying new meds, or increasing dose. My father does not want her to be groggy from meds, but I am wondering if people have had success in using meds to bring LOs out of these depressive, suffering states.
Thanks for any input.

Effexor certainly isn't the first (or second or third!) antidepressant that most dementia specialists would choose. Perhaps there's a reason he felt it made sense for her based on her medical history - it's hard to say.

However, know that switching from Effexor to something else needs to be handled very slowly. If you don't taper down gradually, the psychiatric side effects can be very traumatic.

You mentioned that you're having trouble with this doctor. Could you take her to a doctor outside the facility who might do a better job?

What types of activities do they do at the facility? Does your Mom participate and enjoy them? Is there anyone to encourage her to participate?