Some antidepressants can damage your liver over time, including monoamine oxidase (MAO) inhibitors, tricyclic or tetracyclic antidepressants, bupropion, duloxetine and agomelatine. Antidepressant drugs with a lower risk of liver damage include citalopram, escitalopram, paroxetine and fluvoxamine.
Antidepressants used in therapeutic dosing ranges are associated with causing several adverse drug reactions including hepatotoxicity. Paroxetine, fluoxetine, fluvoxamine, citalopram, mirtazapine and venlafaxine are associated with reversible liver injury upon discontinuation of the agent.
The most used antiepileptic drugs in psychiatry are valproate, carbamazepine, topiramate, lamotrigine and gabapentin. Of these drugs, Valproate is associated with the greatest risk of potential liver toxicity. Gabapentin and pregabalin are the safest[129].
The antidepressants associated with greater risks of hepatotoxicity are iproniazid, nefazodone, phenelzine, imipramine, amitriptyline, duloxetine, bupropion, trazodone, tianeptine, and agomelatine.
Research suggests that less than 1% of people who take Prozac may be at risk of acute liver injury. Such effects on the liver tend to occur 2 to 12 weeks after starting this SSRI. A doctor may recommend monitoring your liver enzymes to detect any issues.
Sertraline therapy can be associated with transient asymptomatic elevations in serum aminotransferase levels and has been linked to rare instances of clinically apparent acute liver injury.
Acetaminophen is the biggest culprit by far, according the review published in AACN Advanced Critical Care, but isn't the only problem drug.
Fluoxetine, a commonly prescribed selective serotonin reuptake inhibitor antidepressant, has been shown to increase hepatic lipid accumulation, a key factor in the development of nonalcoholic fatty liver disease.
For patients with CLD and hepatitis C, selective serotonin reuptake inhibitors (SSRIs) appear to be the safest class of antidepressants.
Studies show that more cases of acute liver failure are caused by prescription and over-the-counter drugs (OTC), herbs, and dietary supplements than all other reasons combined. Some don't show any symptoms, while others cause symptoms to appear.
Serotonin aggravates viral hepatitis, again through vasoactive effects on the microcirculation, and plays a crucial role in the progression of hepatic fibrosis. Finally, serotonin may facilitate tumor growth of primary liver carcinoma like cholangiocarcinoma and hepatocellular carcinoma.
The best antidepressant options for patients with liver failure is desvenlafaxine. This drug is an active metabolite of venlafaxine, with high percentage of unchanged metabolites eliminated in the urine.
Although thought to be generally safe and with minimal drug-drug interactions, clinicians should be aware of the possibility of escitalopram-induced liver injury when initiating depressed patients on antidepressant treatment. This requires extra vigilance as most patients may remain asymptomatic.
Psychotropic medications are potentially at liver risk particularly in cirrhotic patients and their prescription must be carefully. Drug interactions have to be evaluated since the metabolism of psychotropic drugs is mainly hepatic.
Get medical help right away if you have any very serious side effects, including: fast/irregular heartbeat, fainting, black/bloody stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision).
Lexapro (Escitalopram) can cause liver enzymes levels to be elevated, but this is uncommon and occurs in less that 1 % of the cases. Lexapro can cause hepatitis, which in turn causes elevated enzymes, but elevated enzymes due to hepatitis are often far more elevated than what your test results show.
Rare instances of acute, clinically apparent episodes of liver injury with marked liver enzyme elevations with or without jaundice have been reported in patients on citalopram and escitalopram.
It is well known that harms caused by SSRIs can be long-lasting [18] and there are indications that they can even be permanent, e.g. for sexual disturbances [39, 40]. Withdrawal symptoms are also drug harms, and they can also persist for a long time [18].
It's widely known that brain serotonin affects mood, and that most commonly used antidepressant treatment for depression blocks the absorption of serotonin by neurons. It is less widely known, though, that all the major organs of the body -- the heart, kidneys, lungs, liver -- use serotonin from the bloodstream.
Driving and operating machinery. Some SSRIs can cause dizziness, drowsiness and blurred vision, particularly when you first start taking them. If you do experience these symptoms, you shouldn't drive or use heavy tools and machinery. The symptoms should be temporary, but speak to your doctor if you're unsure.
Serotonin syndrome generally doesn't cause any problems once serotonin levels are back to their original levels. If left untreated, severe serotonin syndrome can lead to unconsciousness and death.
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) widely used as an antidepressant. Fluoxetine therapy can be associated with transient asymptomatic elevations in serum aminotransferase levels and has been linked to rare instances of clinically apparent acute liver injury.