Hepatic insufficiency under antidepressant therapy with phenelzine

Véronique Delugeau, Julian Muguerza, Alain Cohen, Serge Goffinet Published in the journal : January 2017 Category : Hépato-gastroentérologie

Summary :

Depression is a major public health concern, with an increasing proportion of the population under antidepressants. Depending on depression severity, different drug regimens are proposed. Among them, monoamine oxidase inhibitors are indicated in the event of resistance to other treatments. We report a case of drug-induced subfulminant hepatitis occurring 2 months after the first use of phenelzine.

Key Words

IMAO, antidepressant, acute hepatic insufficiency

What is already known about the topic?

While many antidepressants may induce toxic hepatitis, this complication is a relatively rare occurrence. Only three cases of acute hepatic insufficiency related to the use of phenelzine have been reported.

What does this article tell us?

Liver damages associated with antidepressants are difficult to diagnose, because the initial symptoms of fatigue, asthenia, anorexia, and nausea can be mistaken for a depression upsurge, erroneously leading to therapeutic escalation. It is thus recommended to monitor transaminase levels every month for the first 6 months after initiating antidepressant therapy.