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Psychotherapeutic Agents in End‐Stage Renal Disease
Author(s) -
Eyler Rachel F.,
Unruh Mark L.,
Quinn Davin K.,
Mary Vilay Aloun
Publication year - 2015
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12370
Subject(s) - medicine , tricyclic , end stage renal disease , dosing , intensive care medicine , adverse effect , disease , pharmacology
Patients with end‐stage renal disease ( ESRD ) are often affected by many comorbid conditions, including mental health disorders. Psychiatric illness among patients with ESRD has been associated with increased risks for nonadherence, hospitalizations, suicide, and all‐cause mortality. We reviewed the pharmacokinetic data available with psychotherapeutic agents, focusing on physiologic data rather than specific dosing recommendations. Unfortunately data regarding the pharmacokinetics, efficacy, and safety of psychotherapeutic agents in ESRD remain rather limited. Of the agents available, it appears that the most data in this patient group were found with selective serotonin reuptake inhibitors and benzodiazepines. Given the small number of patients enrolled in many of the studies and the wide inter‐individual variability, it was difficult to interpret the significance of results in many instances. A number of agents, such as tricyclic antidepressants, were associated with adverse effects that would be imperative to avoid in patients with ESRD . Psychotherapeutic medications should be started at low doses and titrated carefully, while monitoring the efficacy and safety of each agent.