Depression Treatment Is Often Ineffective for Patients with CKD
Sertraline, a selective serotonin reuptake inhibitor, did not improve depressive symptoms among patients with chronic kidney disease (CKD), according to a recent study.
The double-blind, placebo controlled, randomized trial included 201 patients with stage 3, 4, or 5 non-dialysis dependent CKD and major depressive disorder (MDD). After a 1 week placebo run-in period, 102 participants were randomly assigned to receive sertraline and 99 participants were randomly assigned to receive matching placebo for 12 weeks.
__________________________________________________________________
RELATED CONTENT
Depression Symptoms, Adherence Improved With Novel Intervention
Sodium Restriction vs Diuretics: Which Option Is Best For Advanced CKD?
__________________________________________________________________
Using scores from the 16-item Quick Inventory of Depression-Symptomatology—Clinician Rated (QIDS-C16), the researchers assessed improvements in depressive symptoms from baseline to week 12 as the primary outcome. In addition, the secondary outcomes included adverse events and improvements in quality of life, determined using the Kidney Disease Quality of Life Survey-Short Form.
A total of 193 patients with at least 1 outcome assessment were included in the primary analysis. The mean baseline QIDS-C16 score for the sertraline group was 14 and for the placebo group was 14.1.
Overall, QIDS-C16 scores changed by -4.1 among those in the sertraline and by -4.2 among those in the placebo group. Likewise, there were no significant differences in the Kidney Disease Quality of Life Survey between groups.
Additionally, patients receiving sertraline reported more nausea or vomiting (22.7%) and diarrhea (13.4%) compared with placebo (10.4% and 3.1%, respectively).
“Among patients with non–dialysis-dependent CKD and MDD, treatment with sertraline compared with placebo for 12 weeks did not significantly improve depressive symptoms,” the researchers concluded. “These findings do not support the use of sertraline to treat MDD in patients with non–dialysis-dependent CKD.”
—Melissa Weiss
Reference:
Hedayati SS, Gregg LP, Carmody T, et al. Effect of sertraline on depressive symptoms in patients with chronic kidney disease without dialysis dependence: The CAST randomized clinical trial [published online November 3, 2017]. JAMA. doi:10.1001/jama.2017.17131.