The Japanese Journal of Clinical Dialysis Vol.33 No.4(3-6)

Theme The consideration of polypharmacy in dialysis patients
Title Prescription of hypnotic drugs and antidepressants
Publish Date 2017/04
Author Hiroaki Tsujikawa Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Author Kazuhiko Tsuruya Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University / Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University
[ Summary ] Sleep disorders and depression are prevalent in maintenance dialysis patients and have been associated with decreased quality of life and increased morbidity and mortality. The reasons for the high prevalence of these disorders in patients on dialysis include potential intrinsic and environmental causes, such as kidney failure, dialysis, restless legs syndrome, psychosocial stress factors, and so on. These factors may overlap and cause refractory psychological symptoms. Although there is no consensus on a specific treatment for sleep disorders or depression in dialysis patients, it is recommended that non-pharmacologic approaches, such as improvement in sleeping habits and living environment, be used as a first-line approach. The average age of dialysis patients is increasing ; therefore, unexpected side effects of the drugs are likely to occur. Thus, multidrug combinations should be avoided. Psychotropic drugs and drug dosage should be selected based upon the patients' condition, to ensure the patient is not exposed to excess drug concentration.
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