Sertraline Not Effective for Depression in CKD

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No improvement for patients with MDD and chronic kidney disease without dialysis dependence.
No improvement for patients with MDD and chronic kidney disease without dialysis dependence.

(HealthDay News) -- Sertraline treatment does not significantly improve depressive symptoms among patients with non-dialysis-dependent chronic kidney disease (CKD) and major depressive disorder (MDD), according to a study published online in the Journal of the American Medical Association.

S. Susan Hedayati, MD, from the University of Texas Southwestern Medical Center in Dallas, and colleagues conducted a randomized trial involving 201 patients with stage 3, 4, or 5 non-dialysis-dependent CKD. MDD was established using the Mini Neuropsychiatric Interview. Participants were randomly allocated to receive sertraline for 12 weeks or matching placebo (102 and 99 patients, respectively). One hundred ninety-three patients who had at least one outcome assessment after randomization were included in the primary analysis.

The researchers found that there was a change in the 16-item Quick Inventory of Depression Symptomatology-Clinician Rated of −4.1 in the sertraline group and −4.2 in the placebo group (between-group difference, 0.1; 95 percent confidence interval, −1.1 to 1.3; P = 0.82). No significant between-group difference was observed in the change in patient-reported overall health on the Kidney Disease Quality of Life Survey. The sertraline group more often had nausea or vomiting as well as diarrhea.

"These findings do not support the use of sertraline to treat MDD in patients with non-dialysis-dependent CKD," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

References

Hedayati SS, Gregg LP, Carmody T, et al. Effect of Sertraline on Depressive Symptoms in Patients With Chronic Kidney Disease Without Dialysis Dependence: The CAST Randomized Clinical Trial. JAMA. [Epub November 3, 2017]. doi:10.1001/jama.2017.17131

Walther CP, Shah AA, Winkelmayer WC, et al. Treating Depression in Patients With Advanced CKD Beyond the Generalizability Frontier. JAMA. Published online November 3, 2017. doi:10.1001/jama.2017.17553

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