I really enjoyed reading everyone's posts related to this article. For me, this article was very interesting because it directly relates to a client who I am seeing. The client is taking several medications for bipolar disorder and has been on the same regimen for several years. However, he is very depressed, and has been considering trying an antidepressant (it has been a discussion for a while and because of his history of mania, we are moving slowly and cautiously). While I have been seeing him, we have also discovered a new diagnosis of chronic kidney disease. At this point, we have to make a lot of decisions around his kidney function and his current medications and potential new antidepressant. This article has been helpful to have new information around utilizing sertraline with CKD. I know that my client's case is different from those in the article, but it was helpful to understand some of the recent information available about Sertraline. I, too, feel comfortable still prescribing sertraline to client's with CKD, but I wonder if when picking a medication for someone with CKD, if you wouldn't start with escitalopram first since there isn't similar research (because the research hasn't been performed). I think that this article definitely gives me something to think about when moving forward in treatment planning with this client. Thank you to everyone for the compelling conversation.
