Psychotropic Medications and Kidney Disease: Balancing Efficacy, Safety, and Tolerability

Individuals with chronic kidney disease (CKD) commonly experience mental health disorders, including depression and anxiety, which may require treatment with psychotropic medications. Although nephrology nurses and nurse practitioners may not prescribe or administer these medications, they play an important role in monitoring patients receiving psychotropic therapy. Therefore, nephrology nurses and nurse practitioners should have a working knowledge of the pharmacokinetics, pharmacodynamics, efficacy, safety, and tolerability of these medications, particularly in the setting of impaired kidney function. This article provides an overview of selected psychotropic medications commonly used to treat mental health disorders in individuals with CKD, with an emphasis on considerations relevant to nephrology nursing practice. The discussion includes medication efficacy, safety, tolerability, and pharmacokinetic and pharmacodynamic consideration that may affect medication selection and dosing in patients with reduced kidney function. This overview is not intended to be comprehensive or inclusive of all psychotropic medications.