{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T03:27:04Z","timestamp":1768274824105,"version":"3.49.0"},"reference-count":43,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010771","name":"Loo och Hans Ostermans Stiftelse f\u00f6r Medicinsk Forskning","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010771","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2018\u201002213"],"award-info":[{"award-number":["2018\u201002213"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2019\u201001059"],"award-info":[{"award-number":["2019\u201001059"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To avoid adverse drug reactions, dose reductions are recommended when prescribing selective serotonin reuptake inhibitors (SSRIs) to patients with impaired kidney function. The extent of this practice in routine clinical care is however unknown. We aimed to evaluate the starting and maintenance SSRI doses prescribed to patients stratified by levels of kidney function in real\u2010world practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the Stockholm CREAtinine Measurements (SCREAM) project, we identified 101\u2009409 new users of antidepressants (including 52\u2009286 SSRI users) in the region of Stockholm during 2006\u20132019, who were \u226550\u2009years of age and had a recent creatinine test taken in order to estimate glomerular filtration rate (eGFR). SSRI dose reduction was defined as a prescribed SSRI dose of \u22640.5 defined daily doses, according to current recommendations. We examined the associations between eGFR and reductions in initial dose and maintenance dose of SSRIs using logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, reductions in initial and maintenance dose were observed among 54.1% and 34.1% of new SSRI users. Nevertheless, about 40% of individuals with an eGFR &lt;30\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup> were prescribed an SSRI without dose reduction. After adjusting for age and other covariates, lower eGFR was associated with moderately higher odds of dose reduction, for both initial and maintenance dose. Compared to individuals with an eGFR of 90\u2013104\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>, the adjusted odds ratios for those with an eGFR &lt;30\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup> were 1.18 (95% CI: 1.03, 1.36) for initial dose reduction, and 1.49 (1.29, 1.72) for maintenance dose reduction. Stratified analyses showed stronger associations between lower eGFR and SSRI dose reduction among individuals aged 50\u201364\u2009years and in those receiving prescriptions from psychiatric care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lower kidney function was moderately associated with a reduced SSRI dose, independently of age. Prescribing SSRIs to middle\u2010aged and older patients should not only consider patients' age but also their kidney function.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5515","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T07:33:43Z","timestamp":1659598423000},"page":"1091-1101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Kidney function and prescribed dose in middle\u2010aged and older patients starting selective serotonin reuptake inhibitors"],"prefix":"10.1002","volume":"31","author":[{"given":"Nanbo","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Lisinski","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2480-0216","authenticated-orcid":false,"given":"Tyra","family":"Lagerberg","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Johnell","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Jes\u00fas","family":"Carrero","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"issue":"10225","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, regional, and national burden of chronic kidney disease, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"395","author":"G. B. D. Chronic Kidney Disease Collaboration","year":"2020","journal-title":"Lancet"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-11-201306040-00007"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.228"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.77"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.619"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.02.325"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.02.369"},{"key":"e_1_2_12_9_1","volume-title":"Practice Guideline for the Treatment of Patients with Major Depressive Disorder","author":"American Psychiatric Association","year":"2010"},{"key":"e_1_2_12_10_1","volume-title":"Depression in Adults with a Chronic Physical Health Problem: Recognition and Management","author":"National Collaborating Centre for Mental Health","year":"2010"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004867415617657"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716659417"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2009.05.003"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2011.358"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199834040-00002"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs295"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004867414528589"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.01.016"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.45.1.34"},{"key":"e_1_2_12_20_1","volume-title":"VA\/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder","author":"The Management of Major Depressive Disorder Working Group","year":"2022"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780429460418"},{"key":"e_1_2_12_22_1","volume-title":"The Maudsley Prescribing Guidelines in Psychiatry","author":"Taylor DM","year":"2018"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4212"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13418"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1294"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14051"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012113"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60674-5"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2020-300231"},{"key":"e_1_2_12_31_1","unstructured":"Pharmaceutical Specialities in Sweden. FASS for Healthcare Staff.The Swedish Association of the Pharmaceutical Industry AB;2021. Accessed 8 May 2021.https:\/\/www.fass.se\/LIF\/startpage?userType=0"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3040"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-145-4-200608150-00004"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-015-0242-4"},{"key":"e_1_2_12_35_1","unstructured":"Dagens Medicin.Reduce maximum dose for citalopram;2011. Accessed 12 May 2021.https:\/\/www.dagensmedicin.se\/alla-nyheter\/lakemedel\/sankt-maxdos-for-citalopram\/"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13275"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00035"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2016.104"},{"key":"e_1_2_12_39_1","first-page":"CD004541","article-title":"Antidepressants for treating depression in adults with end\u2010stage kidney disease treated with dialysis","volume":"5","author":"Palmer SC","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02120216"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.17131"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.07.015"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13660"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2018101032"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.5515","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pds.5515","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.5515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T18:07:43Z","timestamp":1692727663000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.5515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,10]]},"references-count":43,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1002\/pds.5515"],"URL":"https:\/\/doi.org\/10.1002\/pds.5515","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,10]]},"assertion":[{"value":"2022-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}