title: Cross hepatotoxicity between tricyclic antidepressants and phenothiazines.
abstract: OBJECTIVE
  To describe a case of cross hepatotoxicity between tricyclic antidepressants and phenothiazines.
  
  
  METHODS
  A woman who developed three episodes of drug-induced hepatitis within 3 years as a result of successive treatment with two tricyclic antidepressants, trimipramine and desipramine, and one neuroleptic derivative, cyamemazine.
  
  
  METHODS
  The drugs were withdrawn after the patient experienced liver dysfunction, although bromazepam was later administered with no side effects.
  
  
  RESULTS
  After three episodes of drug-induced hepatitis the patient's serum aspartate aminotransferase and alanine aminotransferase levels returned to normal when the tricyclic antidepressants and cyamemazine were withdrawn.
  
  
  CONCLUSIONS
  Trimipramine, desipramine and cyamemazine are related by their chemical structures which include a tricyclic ring. This suggests that this chemical moiety might be involved in the hepatotoxicity of tricyclic antidepressants and phenothiazine derivatives.
authors.affiliation: Department of Hepato-Gastroenterology, Saint-Eloi Hospital, Montpellier, France.
authors.forename: A J
authors.initials: AJ
authors.lastname: Remy
authors.forename: D
authors.initials: D
authors.lastname: Larrey
authors.forename: G P
authors.initials: GP
authors.lastname: Pageaux
authors.forename: J
authors.initials: J
authors.lastname: Ribstein
authors.forename: J
authors.initials: J
authors.lastname: Ramos
authors.forename: H
authors.initials: H
authors.lastname: Michel
mesh_terms: D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000633:toxicity*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D003891:Desipramine / Q000633:toxicity; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects*; D010640:Phenothiazines / Q000633:toxicity*; D013329:Structure-Activity Relationship; D014299:Trimipramine / Q000633:toxicity
chemical_list: D000929:Antidepressive Agents, Tricyclic; D010640:Phenothiazines; D014299:Trimipramine; C028457:cyamemazine; D003891:Desipramine