Acute Hepatocellular-Cholestatic Liver Injury after Olanzapine Therapy

Jadallah, Κhaled; Limauro, David L.; Colatrella, Anthony M.

doi:10.7326/0003-4819-138-4-200302180-00024

Cited by 25 publications

(4 citation statements)

References 7 publications

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“…9 The exact mechanism of the cholestatic liver damage and transaminase (ALT, AST) elevation induced by olanzapine is not known; however, it might be due to weight gain, chylomicronemia, and TG overload leading to liver steatosis. 35 To the authors' knowledge, this is the first case report of severely elevated TG and liver damage, induced by olanzapine, being successfully treated with medication discontinuation and a change to aripiprazole with a good clinical outcome and relief of side effects. We also note the absence of hypertriglyceridemia and liver problems in the preceding trial with risperidone, suggesting that some patients may have a relatively unique susceptibility to olanzapine toxicity in these areas in contrast to the other atypical antipsychotics.…”

Section: Discussionmentioning

confidence: 93%

Olanzapine-Induced Triglyceride and Aminotransferase Elevations Without Weight Gain or Hyperglycemia Normalized After Switching to Aripiprazole

Pawełczyk

Rabe‐Jabłońska

2014

Journal of Psychiatric Practice

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Olanzapine induced a marked elevation in triglyceride and cholesterol levels and in liver transaminase enzymes after 12 weeks of treatment in a patient with schizophrenia. These changes were not seen in an earlier 10-week course of treatment with risperidone, and improved substantially 1 week after the patient stopped olanzapine and began treatment with aripiprazole. The patient did not exhibit weight gain or hyperglycemia with any of the medications. This case and a review of the literature suggest that olanzapine may have unique properties that affect hepatic enzyme pathways, independent of any effects on weight and glucose, that may lead to hyperlipidemia and transaminitis in some patients.

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Section: Discussionmentioning

confidence: 93%

Olanzapine-Induced Triglyceride and Aminotransferase Elevations Without Weight Gain or Hyperglycemia Normalized After Switching to Aripiprazole

Pawełczyk

Rabe‐Jabłońska

2014

Journal of Psychiatric Practice

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“…Although APs have been prescribed for many decades, systematic analyses of DILI associated with APs are scarce in the current scientific literature 18 . However, there are numerous case reports describing a—in most cases—temporary elevation of transaminases with APs 23–27 . Nowadays, the awareness of the necessity to investigate AP-related DILI seems to increase, and only recently, a study including data from a multicenter drug surveillance program on AP-associated liver injury covering a period of more than 20 years was published 18 .…”

Section: Discussionmentioning

confidence: 99%

“…18 However, there are numerous case reports describing a-in most cases-temporary elevation of transaminases with APs. [23][24][25][26][27] Nowadays, the awareness of the necessity to investigate AP-related DILI seems to increase, and only recently, a study including data from a multicenter drug surveillance program on AP-associated liver injury covering a period of more than 20 years was published. 18 The authors found the highest risk of AP-associated liver injury associated with olanzapine, clozapine, risperidone, quetiapine, amisulpride, and aripiprazole.…”

Section: Current Scientific Literaturementioning

confidence: 99%

Drug-Associated Liver Injury Related to Antipsychotics

Zeiss

Hafner

Schönfeldt‐Lecuona

et al. 2022

J Clin Psychopharmacol

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Background: Drug-associated liver injury is one of the most common causes for acute liver failure and market withdrawal of approved drugs. In addition, the potential for hepatotoxicity related to specific substances has to be considered in psychopharmacotherapy. However, systematic evaluations of hepatotoxicity related to antipsychotics are limited. Methods:We conducted an exploratory case/non-case study and evaluated pharmacovigilance data from VigiBase related to 30 antipsychotics marketed in the European Union. Reporting odds ratios were calculated for antipsychotics associated with the Standardized Medical Dictionary of Regulatory Activities queries "Drug-related hepatic disorders-comprehensive search" (DRHD-CS) and "Drug-related hepatic disorders-severe events only" (DRHD-SEO).Results: We found several signals for drug-associated liver injury including signals for severe events: 17 of 30 antipsychotics were associated with DRHD-CS and 10 of 30 antipsychotics with DRHD-SEO. Amisulpride, fluphenazine, levomepromazine, loxapine, olanzapine, perazine, perphenazine, pipamperone, sulpiride, and thioridazine were associated with both, DRHD-CS and DRHD-SEO. No association with fatal outcomes was detected.Conclusions: Several common antipsychotics are associated with hepatotoxicity, partly also with severe hepatotoxicity. Our data do not allow to account for patient-related risk factors for drug-associated liver injury. This should be addressed in further studies.

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“…Eli Lilly received regulatory approval in the United States and Europe and the drug swiftly became a ‘blockbuster’ medicine. Although liver function tests were found to be elevated in between 8% and 27% of patients undergoing olanzapine treatment (Tollefson et al., 1997), sporadic case reports of liver dysfunction (Jadallah et al., 2003; Ozcanli et al., 2006; Raz et al., 2001; Tchernikovsky & Sirota, 2004) were not followed by more reliable evidence of substantial hepatotoxicity.…”

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confidence: 99%

The first patient to receive olanzapine: A recollection

Baldwin

2021

Human Psychopharmacology

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The first patient to receive olanzapine: A recollectionOlanzapine was approved for general use in patients with schizophrenia 25 years ago, in September 1996: however, the first patient to receive it did so in December 1988, by participating in a safety and dose-finding study of an experimental compound, then designated LY170053, developed by the Eli Lilly pharmaceutical company at its neuroscience research centre in Erl Wood, Surrey.Awareness of the superior efficacy of clozapine when compared to other antipsychotic drugs had encouraged the search for related compounds which might preserve its efficacy and the reduced burden of extrapyramidal adverse effects, whilst avoiding tolerability problems such as weight gain and the risks of neutropenia and agranulocytosis. LY170053 had a marked molecular resemblance to

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Acute Hepatocellular-Cholestatic Liver Injury after Olanzapine Therapy

Cited by 25 publications

References 7 publications

Olanzapine-Induced Triglyceride and Aminotransferase Elevations Without Weight Gain or Hyperglycemia Normalized After Switching to Aripiprazole

Olanzapine-Induced Triglyceride and Aminotransferase Elevations Without Weight Gain or Hyperglycemia Normalized After Switching to Aripiprazole

Drug-Associated Liver Injury Related to Antipsychotics

The first patient to receive olanzapine: A recollection

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