Acute cholestatic hepatitis probably associated with risperidone.
OBJECTIVE
Risperidone is an atypical neuroleptic drug widely used due to the lower incidence and severity of hepatic adverse effects in comparison to phenothiazines. Although idiosyncratic reversible hepatotoxicity may occur in association with risperidone, the interaction with fluoxetine might increase the risk of toxic liver injury in a vulnerable patient.


RESULTS
We present a case of acute cholestatic hepatitis probably associated with the use of risperidone after only a few days of therapy in a patient also treated with fluoxetine. The patient, a 64-year-old male, developed a rapid increase in liver enzymes after starting treatment with only four doses of risperidone 2 mg/day.


CONCLUSIONS
We recommend obtaining baseline liver function tests before starting risperidone and regular monitoring to screen patients for liver damage during therapy whenever a patient is also receiving fluoxetine.
Llinares Tello
Francisca
F
Alicante University General Hospital, Spain. paquillinares@eresmas.com
Hernández Prats
Carmen
C
Bosacoma Ros
Nuria
N
Pérez Martínez
Enrique
E
Climent Grana
Eduardo
E
Navarro Polo
José Noé
JN
Ordovás Baines
Juan Pablo
JP
D000208:Acute Disease; D014150:Antipsychotic Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018967:Risperidone / Q000009:adverse effects*
D014150:Antipsychotic Agents; D018967:Risperidone