title: Trazodone-induced hepatotoxicity: a case report with comments on drug-induced hepatotoxicity.
abstract: Trazodone (Desyrel) is a second-generation, nontricyclic antidepressant that has been in use in North America since the early 1980s. It has the advantage of being more sedating and having less anticholinergic side effects than other secondary amines in the piperazine class, namely, desipramine and nortriptyline. Five previous cases of trazodone hepatotoxicity have been reported in the literature, one describing chronic damage and the others, more acute cellular and cholestatic injury. We describe a case of acute reversible liver injury with the use of trazodone. This case is unique in that injury occurred after protracted (18 months) drug use and while the patient was on corticosteroids. Moreover, the diagnosis was confirmed by an inadvertent challenge with trazodone. This case reports not only a well documented instance of trazodone-induced liver injury, but also serves as a basis for a brief discussion of mechanisms, clinical monitoring, and therapy in drug-induced hepatotoxicity.
authors.affiliation: Department of Medicine, The University of Texas Health Science Center at San Antonio, 78284-7878, USA.
authors.forename: N F
authors.initials: NF
authors.lastname: Fernandes
authors.forename: R R
authors.initials: RR
authors.lastname: Martin
authors.forename: S
authors.initials: S
authors.lastname: Schenker
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007565:Jaundice / Q000139:chemically induced; D008099:Liver / Q000187:drug effects*; D011241:Prednisone / Q000627:therapeutic use; D014196:Trazodone / Q000009:adverse effects*
chemical_list: D000893:Anti-Inflammatory Agents; D018687:Antidepressive Agents, Second-Generation; D005938:Glucocorticoids; D011241:Prednisone; D014196:Trazodone