| Theme | Dialysis Patients and Psychiatric Pharmacotherapy | |
|---|---|---|
| Title | Psychological problems of dialysis (hemodialysis and peritoneal dialysis) patients -- Management and prevention | |
| Publish Date | 1999/08 | |
| Author | Sunao Kaneko | Department of Neuropsychiatry, Hirosaki University |
| Author | Takahiro Itai | Department of Neuropsychiatry, Hirosaki University |
| [ Summary ] | The advantages of CAPD include increased patient autonomy, dietary freedom, and lack of necessity forvascular access. However, CAPD patients must be motivated, intelligent, adequately trained, and possess sufficient manual dexterity and special sensory functions to follow strict sterile techniques. Additional disadvantages are peritonitis and absence of social interactions at the dialysis center. The psychological symptoms observed in CAPD patients are the same as those seen in hemodialysis (HD) patients except for restless legs syndrome (RLS) and impairment of consciousness such as delirium. These 2 symptoms were more frequently observed in CAPD patients than in HD patients, Depression, anxiety, and hypochondriasis are most commonly seen in both CAPD and HD patients, in particular those with symptoms of physical origin and those without sufficient family and financial supports.Those who most need special care such as supportive psychotherapy, family and social intervention, and the support of medical and nursing personnel with CAPD are the elderly, and patients with inadequate social support. The advent of symptoms is strikingly affected by physical complications indicating that active medical interventions for the purpose of treatment of the complications is specifically required for the reduction or prevention of additional psychiatric symptoms. Rational drug therapy i.e. with clonazepam and/or L-DOPA for RLS, antidepressants and/or minor tranquilizers for depression or anxiety symptoms, hypochondriasis, and insomnia, antipsychotic drugs and/or mianserin for delirium, is also needed. |
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