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Psychiatry Education Forum Academy Forums Forum Discussions stimulants and kidney disease Reply To: stimulants and kidney disease

  • Dr. Harvinder Singh

    May 31, 2021 at 9:06 am

    Hi Amelia.

    The “low dose” use of stimulants is safe in the elderly. I will stay cautious in patients with end-stage renal disease (by using lower doses) and not in patients with mild, moderate, or severe renal impairment. Read this study to learn more on this: PubMed.

    Overall, low dose stimulants have shown efficacy in the following disorders in elderly:

    • Geriatric depression secondary to medical illness: Dextroamphetamine (average maximal daily dose of 8.2 mg/day) and methylphenidate (maximal daily dose averaging 9mg/day).
    • Post-stroke depression: Methylphenidate (mean dose of 17mg daily). read more on this topic here: Chapter
    • Major depression resistant to other treatment: Methylphenidate (ranged between 5 and 20 mg daily)
    • Apathy, Negative symptoms with dementia: Methylphenidate (ranging from 10 to 20 mg/day)
    • Improving falls: Methylphenidate (10mg single dose)

    The list is long. Let me know if you want me to post a chapter with a summary on this topic.