title: Psychotherapeutic Agents in End-Stage Renal Disease.
abstract: 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.
authors: School of Pharmacy, University of Connecticut, Storrs, Connecticut.
authors: Rachel F
authors: RF
authors: Eyler
authors: School of Medicine, University of New Mexico, Albuquerque, New Mexico.
authors: Mark L
authors: ML
authors: Unruh
authors: School of Medicine, University of New Mexico, Albuquerque, New Mexico.
authors: Davin K
authors: DK
authors: Quinn
authors: College of Pharmacy, University of New Mexico, Albuquerque, New Mexico.
authors: Aloun Mary
authors: AM
authors: Vilay
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D001523:Mental Disorders / Q000150:complications* / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D017367:Selective Serotonin Reuptake Inhibitors