Antidepressant use in Elderly with Reduced Renal Function.
Clinical Case Discussion: Antidepressants in Elderly with Reduced Renal Function.
Dr. Satinderpal Kaur (Family Medicine) & Dr. Harvinder Singh (Psychiatry) will continue their discussion to integrate clinical cases from Psychiatry and Medicine.
This clinical case discussion #4 will focus on:
- How to choose an antidepressant in elderly patients with reduced renal function.
- Adjusting antidepressant dose based on renal function.
- Chronic Kidney Disease: diagnosis, classification, and treatment.
Here is the summary of what this patient presented with:
This is a case of a 81 year old male presenting with a worsening of major depressive episode with multiple comorbid medication conditions including eGFR of 25 ml/min.
He is currently on following medications:
- Jardiance 25 mg daily
- Ozempic 2 mg every 7 days
- Metoprolol 25 mg twice daily
- Lisinopril 20 mg daily
- Effexor XR 150 mg daily
This patient is on Venlafaxine XR 150 mg with an eGFR of 25 ml/min. Here is one slide from this presentation indicating the recommended Venlafaxine dose with reduced eGFR:
Based on this information, Venlafaxine is not an appropriate choice.
What will be your antidepressant of choice with this patient?
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