Renal and Hepatic Dosing

Hepatic impairment Renal Impairement
Reduce dose by 50% Mild RI: no adjustment;
Moderate RI: 50% reduction;
Severe RI: 75% reduction

A/E Comparison

| SSRI | Anticholinergic | Drowsiness | Insomnia/ agitation | Orthostatic hypotension | QTc prolongation* | Gastrointestinal toxicity | Weight gain | Sexual dysfunction | | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Citalopram | 0 | 1+ | 1+ | 1+ | 2 to 3+Δ | 1+¶ | 1+ | 3+ | | Escitalopram | 0 | 1+ | 1+ | 1+ | 2+ | 1+¶ | 1+ | 3+ | | Fluoxetine | 0 | 0 | 2+ | 1+ | 1+ | 1+¶ | 0 | 3+ | | Fluvoxamine | 0 | 1+ | 1+ | 1+ | 1+ | 1+¶ | 1+ | 3+ | | Paroxetine | 1+ | 2+ | 1+ | 2+ | 1+ | 1+¶ | 2+ | 4+ | | Sertraline | 0 | 1+ | 2+ | 1+ | 1+ | 2+¶◊ | 1+ | 3+ |