Table 2.

Antidepressant drugs and renal function

Drug	Normal adult dose	Dose in renal failure	Comment
Selective serotonin reuptake inhibitors (SSRIs)
Citalopram21	20-60 mg	10-60 mg	Very safe. Fluoxetine may cause loss of appetite at times and insomnia as a side effect
Escitalopram22	10-20 mg	5-20 mg
Fluoxetine23	20-60 mg	20-40 mg
Fluvoxamine24	50-300 mg	50-300 mg
Sertraline25	50-150 mg	50-150 mg
Paroxetine26	20-60 mg	10-30 mg	Dose should be reduced in renal failure May cause seizures at high doses
Tricyclic antidepressants
Amitryptiline27	25-75 mg	25-75 mg	Safe but side effects like constipation, dry mouth, blurred vision. Trazadone may cause priapism at high doses
Imipramine27	25-75 mg	25-75 mg
Doxepin28	25-75 mg	25-75 mg
Amoxapine27	75-200 mg	75-200 mg
Nortryptiline27	25-75 mg	25-75 mg
Trazadone29	150-400 mg	150-300 mg
Newer antidepressants
Venlafaxine30	37.5-225 mg	37.5-225 mg	May increase BP at high doses
Mirtazapine31	15-45 mg	7.5-30 mg	Sedation common
Duloxetine32	10-80 mg	10-80 mg	Safe