Fluoxetine, paroxetine, sertraline, citalopram, and fluvoxamine are SSRIs mostly linked with hepatotoxicity (Table 1). SNRIs venlafaxine and duloxetine, as well as SARI trazodone, are also strongly associated with hepatotoxic side-effects.
Damage may take place within days or up to six months after beginning an antidepressant. The antidepressants that pose the highest risk of liver damage, the investigators concluded, include monoamine oxidase (MAO) inhibitors, tricyclic/tetracyclic antidepressants, nefazodone, bupropion, duloxetine and agomelatine.
Ordinarily, treatments presumed to be associated with a greater risk of hepatotoxicity (iproniazid, nefazodone, tianeptine, phenelzine, imipramine, amitriptyline, duloxetine, bupropion, trazodone, and agomelatine) should not be initiated in individuals with preexisting liver failure.
The antidepressants that seem to have the least potential for hepatotoxicity are citalopram, escitalopram, paroxetine, and fluvoxamine.
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.
Acetaminophen. Taking acetaminophen in excess is the leading cause of drug-induced liver injury.
Fluoxetine, paroxetine, sertraline, citalopram, and fluvoxamine are SSRIs mostly linked with hepatotoxicity (Table
Lorazepam is metabolized by the liver to inactive metabolites and is considered the benzodiazepine best tolerated by patients with advanced liver disease.
Ativan (generic name: lorazepam): Usually works in an hour. Doesn't affect the liver as much as other benzodiazepines—important for patients taking the Pill, cholesterol or ulcer medications, or other drugs that may affect the liver.
These antidepressants generally cause fewer bothersome side effects and are less likely to cause problems at higher therapeutic doses than other types of antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro).
Rare instances of acute liver failure have been attributed to sertraline therapy. Rechallenge usually results in recurrence of liver injury and should be avoided. Persons with intolerance to sertraline may have similar reactions to other SSRIs and careful monitoring is warranted if other such agents are used.
Selective serotonin reuptake inhibitors (SSRIs) are the most prescribed type of antidepressant and include: Fluoxetine. Citalopram.
SSRIs are usually the first choice medicine for depression because they generally have fewer side effects than most other types of antidepressant.
French fries, wafers, burgers, and pizzas do no good to your liver. These food items are high in saturated fat or trans-fat content and are difficult to digest. In other words, your liver needs to work hard to process these food items.
Taking too much acetaminophen (Tylenol, others) is the most common cause of acute liver failure in the United States. Outside of the United States, acetaminophen is known as paracetamol.
The two exceptions to the lack of harm to the liver by higher doses of vitamins are vitamin A and niacin, both of which can cause distinctive forms of liver injury when taken in high doses.