Nephrologists Not Prescribing Antidepressants to Dialysis Patients
Patients on chronic hemodialysis with depression are frequently not interested in modifying or initiating antidepressant treatment, commonly attributing their depression to a recent acute event, chron
(HealthDay News) — Depression is common among kidney failure patients undergoing dialysis, but efforts to get them on antidepressants often fail, according to research published online in the Clinical Journal of the American Society of Nephrology.
The study included 101 dialysis patients who completed monthly questionnaires about depression symptoms. They were followed for at least 1 year. 39 patients were diagnosed with depression, based on assessments from a total of 147 sessions with health care staff.
The researchers found that 70% of sessions showed evidence that the patient was getting antidepressant treatment. In 70% of cases where a nurse recommended that the patient intensify treatment, the patient refused to do so. In 11 of 18 cases where patients agreed they needed depression medication, renal providers were unwilling to prescribe it. The main reason patients refused to take antidepressants was because they felt their depression was attributable to an acute event, chronic illness, or dialysis.
"Our study demonstrated that many patients on chronic hemodialysis have depressive symptoms but do not wish to receive aggressive treatment to alleviate these symptoms," study co-leader Steven Weisbord, MD, of the VA Pittsburgh Healthcare System, said in a journal news release. "We also noted that when patients are willing to accept treatment, renal providers commonly do not prescribe treatment."
- Pena-Polanco JE, Mor MK, Tohme FA, et al. Acceptance of Antidepressant Treatment by Patients on Hemodialysis and Their Renal Providers. Clin J Am Soc Nephrol. 26 January 2017. doi: 10.2215/CJN.07720716 [Epub ahead of print]