What is the best antipsychotic for patients with End-Stage Renal Disease (ESRD)?

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Last updated: June 20, 2025View editorial policy

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From the Research

Quetiapine is often the preferred antipsychotic for patients with End-Stage Renal Disease (ESRD) due to its minimal renal elimination and favorable side effect profile. For ESRD patients, starting with low doses of quetiapine (12.5-25mg daily) and gradually titrating based on response and tolerability is recommended 1. Aripiprazole is another good option as it requires no dose adjustment in renal impairment. Risperidone can be used but requires dose reduction (start at 0.25-0.5mg daily) since its active metabolite accumulates in renal failure. Olanzapine typically needs no dose adjustment but should be used cautiously. Antipsychotics with significant renal elimination like paliperidone should be avoided or used with extreme caution.

When prescribing antipsychotics in ESRD, it's essential to monitor for increased sensitivity to side effects, particularly extrapyramidal symptoms, QTc prolongation, and sedation. Drug selection should be individualized based on the patient's psychiatric symptoms, comorbidities, and dialysis status, with close collaboration between psychiatry and nephrology teams to optimize treatment safety and efficacy. A recent systematic review on antipsychotics and hemodialysis found modest evidence favoring multiple dosing regimens of oral aripiprazole, ziprasidone, olanzapine, and risperidone 2. However, quetiapine's pharmacokinetics in patients with renal or hepatic impairment have been studied, and no clinically significant differences were found when compared to healthy control subjects 1.

Some key points to consider when selecting an antipsychotic for ESRD patients include:

  • Protein binding and clearance by dialysis
  • Duration of the hemodialysis session
  • Route of administration of the antipsychotic
  • Impaired bowel absorption in hemodialysis patients
  • Potential for increased sensitivity to side effects

Overall, quetiapine is a reasonable choice for ESRD patients due to its pharmacokinetic profile and minimal renal elimination 1, but drug selection should always be individualized and guided by collaboration between psychiatry and nephrology teams.

References

Research

Single-dose pharmacokinetics of quetiapine in subjects with renal or hepatic impairment.

Progress in neuro-psychopharmacology & biological psychiatry, 2000

Research

Antipsychotics and hemodialysis: A systematic review.

Asian journal of psychiatry, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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