| Higher dose (mg/day)* | Lower dose (mg/day)* | Systematic review [6]] | ||
---|---|---|---|---|---|
Paroxetine | > 20 | ≤ 20 | • 20 – 50 mg/day | • 20 – 50 mg/day | • 20 – 50 mg/day |
• Reduce by 50% with CrCl < 30 ml/min | • Initiate at 10 mg/day with CrCl < 40 ml/min | • Initiate at 10 mg/day with eGFR < 60 ml/min | |||
Mirtazapine | > 20 | ≤ 20 | • 15 – 45 mg/day | • 15 – 45 mg/day | • 15 – 45 mg/day |
• Use with caution with CrCl < 40 ml/min | • Use with caution | • Use with caution | |||
• Initiate at 15 mg/day with eGFR < 30 ml/min | |||||
Venlafaxine | > 37.5 | ≤ 37.5 | • 75 – 225 mg/day | • 75 – 225 mg/day | • 75 – 225 mg/day |
• Reduce by 25 – 50% with CrCl 10 – 70 ml/min | • Reduce by 25 – 50% with GFR 10–70 ml/min | • Reduce to 37.5 mg/day with eGFR < 30 ml/min | |||
• Initiate at 37.5 mg/day |