Pharmacological and psychological treatment of depression and anxiety among hemodialyzed patients - a review.

Purpose: An overview of the current pharmacological treatment and psychosocial interventions, such as cognitive-behavioral therapy and breathing exercises, for depression and anxiety among hemodialyzed patients (HD). Views: Depression and anxiety are common problems among HD patients, influencing their mortality and morbidity; however, they are often under-recognized and under-treated. Even though the topic is attracting more scientific attention there are still only few studies about methods of treatment for those disorders. Moreover, there are no clear guidelines on pharmacological therapy, which may prove to be difficult among patients with decreased renal function. Psychological interventions such as cognitive-behavioral therapy may be useful in treatment of these mental disorders among HD patients, though reports on the effects of such interventions are scarce. Conclusions: This review outlines some of the current approaches to the treatment of mental disorders among HD patients that use both antidepressants and therapeutic methods. There is an urgent need for randomized clinical trials of both psychosocial and pharmacological interventions in treatment of depressive and anxiety disorders. Currently, both methods seem to be useful; however, they should be implemented with caution until clear guidelines are developed.