Which psychotropic medications induce hepatotoxicity?

Patients with psychiatric disorders are usually more exposed to multiple somatic illnesses, including liver diseases. Specific links are established between psychiatric disorders and alcohol hepatitis, hepatitis B, and hepatitis C in the population as a whole, and specifically in drug abusers. Metabolic syndrome criteria, and associated steatosis or non-alcoholic steato-hepatitis (NASH) are frequent in patients with chronic psychiatric disorders under psychotropic drugs, and should be screened. Some psychiatric medications, such as neuroleptics, mood stabilizers, and a few antidepressants, are often associated with drug-induced liver injury (DILI). In patients with advanced chronic liver diseases, the prescription of some specific psychiatric treatments should be avoided. Psychiatric disorders can be a limiting factor in the decision-making and following up for liver transplantation.

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“…SSRIs mostly implicated in hepatitis onset are paroxetine, fluoxetine, sertraline, and citalopram (61). …”

Section: Resultsmentioning

confidence: 99%

“…Nefazodone market authorization has been consequently interrupted (61). Mirtazapine, monoamine oxidase inhibitors (MAOI), agometaline, a melatonergic antidepressant, and bupropion (61), a norepinephrine-dopamine reuptake inhibitor (NDRI), are rarely associated with liver injury.…”

Section: Resultsmentioning

confidence: 99%

Liver Illness and Psychiatric Patients

et al. 2016

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“…Among mood stabilizers, carbamazepine and valproate have been associated with liver dysfunction and should be avoided in patients with pre‐existing liver disease (Table ).…”

Section: Gastrointestinal Diseasesmentioning

confidence: 99%

Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder

et al. 2015

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People with severe mental illness have a considerably shorter lifespan than the general population. This excess mortality is mainly due to physical illness. Next to mental illness-related factors, unhealthy lifestyle, and disparities in health care access and utilization, psychotropic medications can contribute to the risk of physical morbidity and mortality. We systematically reviewed the effects of antipsychotics, antidepressants and mood stabilizers on physical health outcomes in people with schizophrenia, depression and bipolar disorder. Updating and expanding our prior systematic review published in this journal, we searched MEDLINE (November 2009 -November 2014, combining the MeSH terms of major physical disease categories (and/or relevant diseases within these categories) with schizophrenia, major depressive disorder and bipolar disorder, and the three major psychotropic classes which received regulatory approval for these disorders, i.e., antipsychotics, antidepressants and mood stabilizers. We gave precedence to results from (systematic) reviews and meta-analyses wherever possible. Antipsychotics, and to a more restricted degree antidepressants and mood stabilizers, are associated with an increased risk for several physical diseases, including obesity, dyslipidemia, diabetes mellitus, thyroid disorders, hyponatremia; cardiovascular, respiratory tract, gastrointestinal, haematological, musculoskeletal and renal diseases, as well as movement and seizure disorders. Higher dosages, polypharmacy, and treatment of vulnerable (e.g., old or young) individuals are associated with greater absolute (elderly) and relative (youth) risk for most of these physical diseases. To what degree medication-specific and patient-specific risk factors interact, and how adverse outcomes can be minimized, allowing patients to derive maximum benefits from these medications, requires adequate clinical attention and further research.

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“…Liver impairment shows clinicopathologic features that range from transient liver enzyme elevations to even fulminant hepatic failure. Traditional antidepressants such as monoamine oxidase inhibitors or tricyclic antidepressants appear to have the highest risk to induce liver damage compared with the novel selective serotonin reuptake inhibitors (SSRIs) [56,57]. In some databases of drug-induced liver diseases, antidepressants account for up to 5% of reported cases, while SSRIs have a low incidence of hepatotoxicity from 1.28 to 3.62 cases per patient-year and, among them, the incidence with sertraline is the lowest of its group with 1.28 (0.42-3) cases per patientyear [58].…”

Section: Drugs To Treat Hiv Infectionmentioning

confidence: 99%

Agents and drugs: precautions in patients with cirrhosis

Stickel

2015

Cirrhosis: A Practical Guide to Management

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Which psychotropic medications induce hepatotoxicity?

Cited by 24 publications

References 130 publications

Liver Illness and Psychiatric Patients

Liver Illness and Psychiatric Patients

Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder

Agents and drugs: precautions in patients with cirrhosis

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