Psychiatr. praxi. 2025;26(2):116-122 | DOI: 10.36290/psy.2025.020

Altered pharmacokinetics of selected psychopharmaceuticals in patients with chronic kidney disease

Mgr. Michaela Jelínková1, PharmDr. Jan Miroslav Hartinger, Ph.D.2
1 Oddělení klin. farmacie, Fakultní nemocnice Královské Vinohrady, Farmakologický ústav 1. LF UK a VFN, Praha
2 Farmakologický ústav 1. LF UK a VFN, Praha

Psychiatric illness and delirious states treated with psychopharmaceuticals are common comorbidities in patients with renal impairment. Although the conventional wisdom is that most psychopharmaceuticals are lipophilic in nature and are not renally eliminated, this is not true for a number of commonly administered drugs, and their dosing needs to be adjusted in patients with chronic kidney disease (CKD) or acute kidney injury (AKI). The present article focuses on the effect of impaired renal function and extracorporeal elimination methods on renally eliminated psychopharmaceuticals, especially thiapride, amisulpride, sulpiride, risperidone, paliperidone, venlafaxine, lithium and others. Attention is also given to the effect of hypoproteinemia that develops in patients with nephrotic syndrome on the pharmacokinetics and safety of valproate therapy.

Keywords: acute kidney injury, chronic kidney injury, hemodialysis, antipsychotics, antidepressants, mood stabilizers.

Accepted: June 9, 2025; Published: July 4, 2025  Show citation

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Jelínková M, Hartinger JM. Altered pharmacokinetics of selected psychopharmaceuticals in patients with chronic kidney disease. Psychiatr. praxi. 2025;26(2):116-122. doi: 10.36290/psy.2025.020.
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