Use of sertraline and agomelatine in hemodialysis patients:  A case series report

Alicja Kubanek; Mateusz Przybylak; Przemysław Paul; Anna Sylwia Kowalska; Michał Błaszczyk; Aleksandra Macul-Sanewska; Marcin Renke; Przemysław Rutkowski; Leszek Bidzan; Jakub Grabowski

doi:10.18388/abp.2020_6936

Alicja Kubanek Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland https://orcid.org/0000-0002-0771-6381
Mateusz Przybylak Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
Przemysław Paul Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland
Anna Sylwia Kowalska ISPL Anna Sylwia Kowalska, 80-156 Gdańsk, Poland
Michał Błaszczyk Adult Psychiatry Scientific Circle, Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
Aleksandra Macul-Sanewska Adult Psychiatry Scientific Circle, Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
Marcin Renke Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdansk, 80-210 Gdańsk, Poland
Przemysław Rutkowski Department of Internal and Paediatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdańsk, Poland
Leszek Bidzan Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland
Jakub Grabowski Division of Developmental, Psychotic and Geriatric Psychiatry, Department of Psychiatry, Medical University of Gdansk, 80-210 Gdańsk, Poland

DOI: https://doi.org/10.18388/abp.2020_6936

Abstract

Objective: Major depressive disorder (MDD) is one of the most common psychiatric issues in hemodialysis population. However, the research on proper diagnostic tools and its treatment is still insufficient. The study was performed to investigate the safety and effectiveness of sertraline and agomelatine in a group of hemodialysis patients. Patients and Methods: 78 adult patients from one dialysis centre in Poland were included into the study. The Beck Depression Inventory II (BDI-II) was used to screen for depressive symptoms and was followed by the clinical interview with the psychiatrist. Nine patients diagnosed with major depressive disorder received antidepressant treatment with sertraline or agomelatine, according to the best clinical practice. The additional treatment with vortioxetine was used if the initial one was not effective. The time of observation was 24 weeks. The psychiatric follow up as well as the laboratory data were obtained during the course of observation. Results: All patients receiving sertraline achieved remission of depressive symptoms. In patients receiving agomelatine no remission was observed despite dose augmentation. The side effects of antidepressants were mild and did not result in treatment discontinuation. No abnormalities in liver enzymes levels were observed. In five cases the significant decrease of haemoglobin level was noticed, with no cases of bleeding reported. Conclusion: In patients receiving sertraline the antidepressant effect was satisfactory. No remission of depressive symptoms was observed in patients taking agomelatine. The side effects of antidepressants were mild and transient. Further research on depression treatment in hemodialysis patients is needed, including newer medications.