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Management of Depression in Dialysis Patients

  • Jon Streltzer

Abstract

While depression seems to be the most common psychiatric complication of end stage renal disease (ESRD),(1) reports of treatment are few and primarily anecdotal. Recommendations for treatment generally include psychotherapeutic support and psychiatric liaison activities such as providing support to nursing staff and guiding nurses and physicians in their interactions with dialysis patients.(2) While tricyclic antidepressant medications have been recommended in dialysis populations, reports of their use are rare and there are no controlled studies. Rosser(3) reported measurements of plasma antidepressant levels in three dialysis patients. Each patient had unusually high plasma levels relative to their small oral doses. One patient demonstrated excellent recovery and a second patient had partial recovery. The third patient died from a cardiac arrhythmia possibly induced by the antidepressant medication. Thus, there are no clear guidelines to help determine the benefits and risks of tricyclic antidepressants in a dialysis population.

Keywords

Depressive Symptom Dialysis Patient Depressed Mood Major Depressive Episode Adjustment Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • Jon Streltzer
    • 1
  1. 1.Department of Psychiatry and Institute of Renal Diseases St. Francis HospitalJohn A. Burns School of MedicineHonolulu, HawaiiUSA

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