The Case for Selective Withdrawal of Antidepressants in Patients with Advanced Kidney Disease

Chilcot, Joseph; Farrington, Ken

doi:10.1681/asn.2019030308

Cited by 15 publications

(8 citation statements)

References 9 publications

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“…Antidepressants (most commonly Sertraline) showed no reliable benefits across studies and adverse events were common. Despite these findings, antidepressant use appears high in people living with CKD (Friedli et al, 2017; Van Oosten et al, 2021), and concerns have been raised about some agents' potential for QT prolongation and associated sudden cardiac death (Assimon et al, 2019; Chilcot & Farrington, 2019). However, it is important to note that few RCTS of antidepressants have been conducted in people living with CKD, and trials have generally needed to screen a very high number of patients, partly due to patient selection (e.g., never having been on an antidepressant; screening thresholds etc).…”

Section: Discussionmentioning

confidence: 99%

Approaches to the identification and management of depression in people living with chronic kidney disease: A scoping review of 860 papers

Pearce

Hall

Hudson

et al. 2023

Journal of Renal Care

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Background: Depression is prevalent across the spectrum of Chronic Kidney Disease and associated with poorer outcomes. There is limited evidence regarding the most effective interventions and care pathways for depression in Chronic Kidney Disease.Objectives: To investigate how depression is identified and managed in adults with Chronic Kidney Disease.Design: Scoping review.Methods: Systematic search of eight databases with pre-defined inclusion criteria.Data relevant to the identification and/or management of depression in adults with Chronic Kidney Disease were extracted.Results: Of 2147 articles identified, 860 were included. Depression was most identified using self-report screening tools (n = 716 studies, 85.3%), with versions of the Beck Depression Inventory (n = 283, 33.7%) being the most common. A total of 123 studies included data on the management of depression, with nonpharmacological interventions being more frequently studied (n = 55, 45%). Cognitive Behavioural Therapy (n = 15) was the most common nonpharmacological intervention, which was found to have a significant effect on depressive symptoms compared to controls (n = 10). However, how such approaches could be implemented as part of routine care was not clear. There was limited evidence for antidepressants use in people with Chronic Kidney Disease albeit in a limited number of studies.

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Section: Discussionmentioning

confidence: 99%

Approaches to the identification and management of depression in people living with chronic kidney disease: A scoping review of 860 papers

Pearce

Hall

Hudson

et al. 2023

Journal of Renal Care

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“…This extends to communication with GPs, who appear to manage the prescription and monitoring of antidepressants according to centres. Since evidence for antidepressants in people with CKD is inconclusive and adverse events are common, continued monitoring is vital (Chilcot & Farrington, 2019;Friedli et al, 2017;Hedayati et al, 2017;Pearce et al, 2023). Integrated psychosocial pathways should therefore incorporate GPs, navigating care to kidney psychosocial teams and general hospital liaison psychiatry (Coyne & Fretwell, 2022).…”

Section: Discussionmentioning

confidence: 99%

European Business Environment

Somers¹,

Hall²,

Leeuwen³

et al. 2019

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Background: Depression is common in people with chronic kidney disease, yet little is known about how depression is identified and managed as part of routine kidney care.Objectives: The primary objective was to survey all UK adult kidney centres to understand how depression is identified and managed. A secondary objective was to broadly describe the variability in psychosocial care.Design: Online survey. Methods:The survey comprised of three sections: (1) general kidney care,(2) psychological provision and (3) social work provision.Results: 48/68 (71%) of centres responded to the general survey with 20 and 13 responses from psychological and social work module respectively. Only 31.4% reported having both in centre psychological and social work practitioners. Three

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“…Our reason for this interest stems from the retrospective analysis (albeit in haemodialysis patients and not CKD), which found that patients who initiated selective serotonin reuptake inhibitors (SSRIs) with higher QT-prolonging potential (citalopram, escitalopram) had a significantly increased risk of sudden cardiac death [aHR 1.18 (95% CI 1.05–1.31)] compared with patients who initiated SSRIs with lower QT-prolonging potential (fluoxetine, fluvoxamine, paroxetine and sertraline) [ 4 ]. We have previously raised the possibility that in some kidney patients, antidepressants may be doing more harm than good and suggest that trials evaluating the selective withdrawal of antidepressants in suitable patients may be appropriate [ 5 ].…”

mentioning

confidence: 99%

Depression and clinical outcomes in CKD: do anti-depressants play a role? (EQUAL study)

Chilcot

Picariello

Farrington

2022

Clinical Kidney Journal

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The Case for Selective Withdrawal of Antidepressants in Patients with Advanced Kidney Disease

Cited by 15 publications

References 9 publications

Approaches to the identification and management of depression in people living with chronic kidney disease: A scoping review of 860 papers

Approaches to the identification and management of depression in people living with chronic kidney disease: A scoping review of 860 papers

European Business Environment

Depression and clinical outcomes in CKD: do anti-depressants play a role? (EQUAL study)

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