The prevalence of psychiatric disorders has been well documented in individuals with renal insufficiency. Although not robust, data exists to guide medication choices and dosing strategies in patients with renal insufficiency and those on dialysis.

  • How should medications be dosed in patients with renal insufficiency or those on dialysis?9-16


  1. Guide to Renal/Dialysis Considerations. JCPNP. 2002; 1(1). [Weblink]
  2. Aronoff et al. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children – 5th Ed. 2007. Philadelphia, PA. American College of Physicians. ISBN 1-930513-76-3, ISBN 978-1-930513-76-1
  3. Seyffart G. Seyffart’s Directory of Drug Dosage in Kidney Disease. 2011. Munich-Orlando. Dustri-Verlag Dr. Karl Feistle GmbH & Co. KG. ISBN 978-3-87185-400-2
  4. Eyler RF, Unruh ML, Quinn DK, Vilay AM. Psychotherapeutic Agents in End-Stage Renal Disease. Semin Dial. 2015;28(4):417-26. DOI: 10.1111/sdi.12370. PubMed PMID: 25857865.
  5. Mathew RO, Bettinger JJ, Wegrzyn EL, Fudin J. Pharmacotherapeutic considerations for chronic pain in chronic kidney and end-stage renal disease. JPR. 2016;9:1191-1195. DOI: 10.2147/JPR.S125270. PubMed PMID: 27994481; PubMed Central PMCID: PMC5153274.
  6. Valli S. Affect of renal dysfunction and dialysis on select psychotropic medications. 2/21/2016. [Weblink]
  7. Whittaker CF, Miklich MA, Patel RS, Fink JC. Medication Safety Principles and Practice in CKD. CJASN. 2018;13(11):1738-1746. DOI: 10.2215/CJN.00580118. PubMed PMID: 29915131; PubMed Central PMCID: PMC6237057.
  8. Bautovich A, Katz I, Smith M, Loo CK, Harvey SB. Depression and chronic kidney disease: A review for clinicians. Aust N Z J Psychiatry. 11th ed. 2014;48(6):530-41. DOI: 10.1177/0004867414528589. PubMed PMID: 24658294.
  9. Chen L, Greenberg WM, Brand-Schieber E, Wangsa J, Periclou A, Ghahramani P. Effect of renal impairment on the pharmacokinetics of levomilnacipran following a single oral dose of levomilnacipran extended-release capsule in humans. DDDT. 2015;9:3293-300. DOI: 10.2147/DDDT.S85418. PubMed PMID: 26150701; PubMed Central PMCID: PMC4485797.
  10. Shirazian S, Grant CD, Aina O, Mattana J, Khorassani F, Ricardo AC. Depression in Chronic Kidney Disease and End-Stage Renal Disease: Similarities and Differences in Diagnosis, Epidemiology, and Management. Kidney Int Reports. 2017;2(1):94-107. DOI: 10.1016/j.ekir.2016.09.005. PubMed PMID: 29318209; PubMed Central PMCID: PMC5720531.