Renal Impairment and Dose Adjustment of Long-Acting Injectable Antipsychotics: Are We Getting It Right? A Case Report.

Abstract

Renal impairment is defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² with or without kidney damage. Creatinine, which is found in serum and urine, is a common biomarker to estimate renal function and is used in most eGFR equations. Renal impairment can decrease or increase drug effects, necessitating therapeutic adjustments. Increased effect is related to drug accumulation that leads to increased elimination time and potential toxicity. eGFR plays a crucial role in drug dosing, particularly for renally excreted medications. However, the lack of recognition of pre-existing renal impairment and the incorrect interpretation of eGFR equations remain challenges. This case report explores the significance of eGFR in patients with psychiatric conditions, especially in the context of long-acting antipsychotic drug dosing.