Higher dose weekly fluoxetine in hemodialysis patients: A case series report.
Higher dose weekly fluoxetine in hemodialysis patients: A case series report.
复制标题
DOI：
10.1177/0091217420913399
复制
发表时间：
2021-01
影响因子：
2
通讯作者：
Sajatovic M
中科院分区：
文献类型：
--
作者：
Kauffman KM;Dolata J;Figueroa M;Gunzler D;Huml A;Pencak J;Sehgal AR;Sajatovic M
抗抑郁药物氟西汀每周剂量90 mg，与标准制剂氟西汀20 mg每日剂量相同，对重度抑郁障碍(MDD)患者有效且安全。每周一次的氟西汀在血液透析患者中还没有得到很好的研究，而且在这一人群中还没有描述超过90毫克/周的剂量。这个病例系列源自一项关于血液透析患者抑郁的大型研究，描述了每周剂量超过90 mg/周的氟西汀的使用情况。具有抑郁症状严重程度的血液透析患者在9项患者健康问卷上的≥评分为10分，并经迷你国际神经精神病学访谈(MINI)确认为MDD，最初每天服用氟西汀2周，然后过渡到每周服用氟西汀。剂量滴定由开处方的临床医生自行决定。氟西汀治疗共12周。4名年龄24-65岁的血液透析患者开始每周服用氟西汀，剂量从几周增加到180毫克。副作用包括躁动、口干、镇静和头晕。两名患者最终将每周服用的氟西汀降至90毫克。然而，作为研究后后续护理的一部分，所有4名患者都继续每周服用一次氟西汀，不再符合MDD的诊断标准。对于抗抑郁药物反应部分或不足的血液透析患者，每周剂量为180 mg的氟西汀可能是一个合理的治疗考虑。副作用可能会限制某些人对180毫克剂量的耐受性。未来的研究应该调查每周服用氟西汀在这一人群中的长期健康结果。
The antidepressant medication fluoxetine at 90mg dosed weekly is as effective and safe as standard formulation fluoxetine 20mg dosed daily in patients with major depressive disorder (MDD). Weekly fluoxetine has not been well-studied in hemodialysis patients, and doses beyond 90mg/week have not been described in this population. This case series, derived from a larger study on depression in hemodialysis patients, describes the use of weekly fluoxetine at dosages beyond 90mg/week. Hemodialysis patients with depressive symptom severity scored ≥ 10 on the 9-item Patient Health Questionnaire (PHQ9) and MDD confirmed with Mini International Neuropsychiatric Interview (MINI), were initially prescribed daily fluoxetine for 2 weeks then transitioned to weekly fluoxetine. Dosage titration was made at the discretion of the prescribing clinician. Fluoxetine was continued for a total of 12 weeks. 4 women, ages 24–65 years, on hemodialysis for 1 to 18 years, were started on weekly fluoxetine that was increased over several weeks up to 180mg. Side effects included restlessness, dry mouth, sedation and lightheadedness. Two patients ultimately had their weekly fluoxetine decreased back to 90mg. However, all 4 continued weekly fluoxetine as part of post-study aftercare and no longer met diagnostic criteria for MDD, current episode. Weekly fluoxetine at doses of 180mg may be a reasonable treatment consideration for hemodialysis patients who have partial or insufficient antidepressant response. Side effects may limit tolerance of the 180mg dose in some individuals. Future research should investigate longer-term health outcomes of weekly-fluoxetine in this population.
登录
查看更多内容
影响因子：
3.2
作者：
Buongiorno, PA;Plewes, JM;Wilson, MG
通讯作者：
Wilson, MG
影响因子：
11.5
作者：
Wagstaff, AJ;Goa, KL
通讯作者：
Goa, KL
DOI：
10.2215/cjn.00030505
发表时间：
2006-05-01
影响因子：
9.8
作者：
Boulware, L. Ebony;Liu, Yongmei;Powe, Neil R.
通讯作者：
Powe, Neil R.
影响因子：
56.9
作者：
LEMBERGER, L;ROWE, H;WONG, DT
通讯作者：
WONG, DT
影响因子：
5.3
作者：
Schmidt, ME;Fava, M;Judge, R
通讯作者：
Judge, R