Efficacy and tolerability of Escitalopram in patients with chronic kidney disease undergoing hemodialysis having depressive disorder

Depression has been linked to poor quality of life, pain and sleep parameters in several studies. Treatment of depression in patients with Chronic Kidney Disease is likely to improve depression and enhance quality of life, as also increasing length of life. Majority of psychotropic medications can be safely used in Chronic Kidney Disease population. Most of these drugs are fat soluble, cross blood brain barrier, non-dialyzable, metabolized in the liver and excreted through bile. Psychopharmacological trials with Escitalopram in patients with depressive disorder undergoing hemodialysis are in the form of case reports and case series. ESRD has minimal impact on clearance of Escitalopram. This study intended to study the efficacy and tolerability of Escitalopram in patients of CKD undergoing hemodialysis with Depressive disorder. The study included Chronic Kidney Disease patients with Major Depressive disorders undergoing Hemodialysis in Department of Nephrology, SDM College of Medical Sciences and Hospital, Dharwad. Patient with CKD having depressive disorder who are advised Escitalopram were evaluated for improvement in the symptoms and development of side effects, after the treatment course with Escitalopram in a dose ranging from 5-20 mg/day were studied on 4, 8, 12 weeks during their follow up administering Hindi Mental Status Examination (HMSE), Hamilton Depression Rating Scale (HAM-D), Global Assessment of Functioning Scale, Systematic Assessment for Treatment Emergent Events (SAFTEE SCALE), Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index This resulted in significant reduction in symptomatology of depression with minimum tolerability issues