Disturbances of Liver Function by Long Acting Neuroleptic Drugs

Wa, Nolen; Borger, James A.

doi:10.1055/s-0028-1094579

Cited by 4 publications

References 1 publication

(1 reference statement)

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Pregnancy and Breastfeeding

2021

The Maudsley Prescribing Guidelines in Psychiatry

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Lifestyle factors have an important influence on pregnancy outcome. It is well established that smoking cigarettes, eating a poor diet and drinking alcohol during pregnancy can have adverse consequences for the foetus. The manufacturers of cariprazine have advised against its use in pregnancy because of an increased risk of malformations noted in animal studies. Women who take antidepressants during pregnancy may be at increased risk of developing hypertension, preeclampsia and postpartum haemorrhage. Lithium exposure during pregnancy has been associated with an increased risk of congenital anomalies. Anxiety disorders and insomnia are commonly seen in pregnancy. The long‐term benefits of breastfeeding on child physical health and cognitive development are well known. Discussions about the safety of drugs in breastfeeding should be held as early as possible ideally before conception or early in pregnancy. It is usually advisable to continue the antidepressant prescribed during pregnancy.

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Pregnancy and Breastfeeding

2021

The Maudsley Prescribing Guidelines in Psychiatry

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Hepatic and Renal Impairment

2021

The Maudsley Prescribing Guidelines in Psychiatry

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Patients with hepatic impairment may have: reduced capacity to metabolise, reduced ability to synthesise, and reduced hepatic blood flow. Liver function tests (LFTs) are a poor marker of hepatic metabolising capacity, as the hepatic reserve is large. There are few clinical studies relating to the use of psychotropic drugs in people with hepatic disease. The development of metabolic syndrome may be linked to the emergence of non‐alcoholic fatty liver disease later in treatment. Of those treated with antidepressants, 0.5‐3% develop asymptomatic mild elevation of hepatic transaminases. Almost any type of liver damage can occur, ranging from mild transient asymptomatic increases in LFTs to fulminant hepatic failure. Using drugs in patients with renal impairment needs careful consideration. This is partly because some drugs are nephrotoxic but principally because the pharmacokinetics of drugs are altered in renal impairment.

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