Pharmacological treatment for mental health illnesses in adults receiving dialysis: A scoping review

IF 2.1 4区医学 Q3 PHARMACOLOGY & PHARMACY Fundamental & Clinical Pharmacology Pub Date : 2024-06-15 DOI:10.1111/fcp.13022

Jenny Wichart, Peter Yoeun, Tracy Chin, Christopher Evernden, Charlotte Berendonk, Jodi Kerr, Alexandra Birchall, Belinda Boschee, Kimberly Defoe, Jasleen Dhaliwal, Tasia KarisAllen, Megan Kennedy, Alexis McDonald, Monika K. Mierzejewski, Kara Schick-Makaroff

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Abstract

Background

Pharmacologic management of mental health illnesses in patients receiving dialysis is complex and lacking data.

Objective

Our objective was to synthesize published data for the treatment of depression, bipolar and related disorders, schizophrenia or psychotic disorders, and anxiety disorders in adults receiving hemodialysis or peritoneal dialysis.

Methods

We undertook a scoping review, searching the following databases: Medline, Embase, CINAHL, PsycINFO, Cochrane Library, Scopus, and Web of Science. Data on patients who received only short-term dialysis, a kidney transplant, or non-pharmacologic treatments were excluded.

Results

Seventy-three articles were included: 41 focused on depression, 16 on bipolar disorder, 13 on schizophrenia and psychotic disorders, 1 on anxiety disorders, and 2 addressing multiple mental health illnesses. The majority of depression studies reported on selective serotonin reuptake inhibitors (SSRIs) as a treatment. Sertraline had the most supporting data with use of doses from 25 to 200 mg daily. Among the remaining SSRIs, escitalopram, citalopram, and fluoxetine were studied in controlled trials, whereas paroxetine and fluvoxamine were described in smaller reports and observational trials. There are limited published data on other classes of antidepressants and on pharmacological management of anxiety. Data on treatment for patients with bipolar disorder or schizophrenia and related disorders are limited to case reports.

Conclusion

Over half of the studies included were case reports, thus limiting conclusions. More robust data are required to establish effect sizes of pharmacological treatments prior to providing specific recommendations for their use in treating mental health illnesses in patients receiving dialysis.

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接受透析治疗的成人精神疾病的药物治疗：范围综述。

背景：透析患者精神疾病的药物治疗非常复杂且缺乏数据：我们的目的是综合已发表的有关治疗接受血液透析或腹膜透析的成人抑郁症、双相情感障碍和相关障碍、精神分裂症或精神病性障碍以及焦虑症的数据：我们对以下数据库进行了范围界定研究Medline、Embase、CINAHL、PsycINFO、Cochrane Library、Scopus 和 Web of Science。仅接受短期透析、肾移植或非药物治疗的患者的数据被排除在外：结果：共收录了 73 篇文章：41篇侧重于抑郁症，16篇侧重于躁郁症，13篇侧重于精神分裂症和精神病，1篇侧重于焦虑症，2篇涉及多种精神疾病。大多数抑郁症研究报告都将选择性血清素再摄取抑制剂（SSRIs）作为一种治疗方法。舍曲林的支持性数据最多，每日使用剂量从 25 毫克到 200 毫克不等。在其余的 SSRIs 中，艾司西酞普兰、西酞普兰和氟西汀是在对照试验中研究的，而帕罗西汀和氟伏沙明则是在较小的报告和观察试验中描述的。关于其他类别的抗抑郁药和焦虑症的药物治疗，已发表的数据十分有限。关于治疗双相情感障碍或精神分裂症及相关疾病患者的数据仅限于病例报告：结论：半数以上的研究为病例报告，因此限制了结论的得出。在对透析患者的精神疾病治疗提出具体建议之前，需要更多可靠的数据来确定药物治疗的效果大小。

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来源期刊

Fundamental & Clinical Pharmacology 医学-药学

CiteScore

5.30

自引率

6.90%

发文量

111

审稿时长

6-12 weeks

期刊介绍： Fundamental & Clinical Pharmacology publishes reports describing important and novel developments in fundamental as well as clinical research relevant to drug therapy. Original articles, short communications and reviews are published on all aspects of experimental and clinical pharmacology including: Antimicrobial, Antiviral Agents Autonomic Pharmacology Cardiovascular Pharmacology Cellular Pharmacology Clinical Trials Endocrinopharmacology Gene Therapy Inflammation, Immunopharmacology Lipids, Atherosclerosis Liver and G-I Tract Pharmacology Metabolism, Pharmacokinetics Neuropharmacology Neuropsychopharmacology Oncopharmacology Pediatric Pharmacology Development Pharmacoeconomics Pharmacoepidemiology Pharmacogenetics, Pharmacogenomics Pharmacovigilance Pulmonary Pharmacology Receptors, Signal Transduction Renal Pharmacology Thrombosis and Hemostasis Toxicopharmacology Clinical research, including clinical studies and clinical trials, may cover disciplines such as pharmacokinetics, pharmacodynamics, pharmacovigilance, pharmacoepidemiology, pharmacogenomics and pharmacoeconomics. Basic research articles from fields such as physiology and molecular biology which contribute to an understanding of drug therapy are also welcomed.