Antidepressant-induced hepatotoxicity.
Depression is a chronic, severe and increasingly prevalent illness associated with substantial morbidity, mortality and healthcare costs. Antidepressant drugs, the cornerstone of depression treatment, are not devoid of adverse effects, including hepatotoxicity. To review the risk of liver toxicity related to major antidepressants, the authors have followed structural criteria focusing on the underlying mechanism presumably involved and the role of particular chemical structures. The clinicopathological expression goes from transient increases in liver enzymes to fulminant liver failure. Classical antidepressants such as monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs) seem to have the highest potential to induce liver damage compared with the newer drugs such as selective serotonin re-uptake inhibitors (SSRIs). The potential for severe hepatotoxicity associated with nefazodone is stressed. Guidelines for therapy and prevention of antidepressant-induced hepatotoxicity are also discussed.
Lucena
M Isabel
MI
Instituto de Farmacoepidemiología de la Universidad de Valladolid, Spain.
Carvajal
Alfonso
A
Andrade
Raúl J
RJ
Velasco
Alfonso
A
D000928:Antidepressive Agents / Q000009:adverse effects* / Q000737:chemistry / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D056487:Chemical and Drug Induced Liver Injury, Chronic / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use
D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors