Table 5: Select SSRI Antidepressant Dosage Modifications in Renal Impairment

Drug Name  Dosage in Renal Impairment
Citalopram Severe renal impairment (creatinine clearance less than 20 mL/min): use cautiously, as potential exists for active metabolites to accumulate with associated adverse effects
Escitalopram Severe renal impairment (creatinine clearance less than 20 mL/min):  use cautiously, as specific dosage guidelines not available
Paroxetine (Paxil®, Pexeva®, Paxil CR®) Serum levels, AUC increase as renal function declines; therefore, maximum doses when creatinine clearance less than 30 mL/min are:
  • IR: 40 mg/day
  • CR: 50 mg/day

Legend:

  • CR = controlled-release
  • IR = immediate-release