Case against use of antidepressants in chronic medical illnesses

Effect of sertraline on depressive symptoms in patients with chronic kidney disease without dialysis dependence: The CAST randomized clinical trial

JAMA — | November 09, 2017

Hedayati SS, et al. – The researchers investigated the effect of sertraline on depressive symptoms in patients with chronic kidney disease (CKD) and major depressive disorder (MDD). Compared with placebo, treatment with sertraline for 12 weeks did not significantly improve depressive symptoms among patients with non–dialysis-dependent CKD and MDD. In patients with non–dialysis-dependent CKD, these findings did not support the use of sertraline to treat MDD.

Note: The results parallel other negative studies for the treatment of depression in older adults with metabolic syndrome, ischemic heart disease, CHF, and asthma. Also, one study showed nortriptyline was better than escitalopram for inflammatory conditions with high CRP >2.

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