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Review
. 2017 Feb 6;8(1):26-38.
doi: 10.4292/wjgpt.v8.i1.26.

Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity

Diogo Telles-Correia  1 , António Barbosa  1 , Helena Cortez-Pinto  1 , Carlos Campos  1 , Nuno B F Rocha  1 , Sérgio Machado  1
Affiliations
Review

Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity

Diogo Telles-Correia et al. World J Gastrointest Pharmacol Ther. .

Abstract

The liver is the organ by which the majority of substances are metabolized, including psychotropic drugs. There are several pharmacokinetic changes in end-stage liver disease that can interfere with the metabolization of psychotropic drugs. This fact is particularly true in drugs with extensive first-pass metabolism, highly protein bound drugs and drugs depending on phase I hepatic metabolic reactions. Psychopharmacological agents are also associated with a risk of hepatotoxicity. The evidence is insufficient for definite conclusions regarding the prevalence and severity of psychiatric drug-induced liver injury. High-risk psychotropics are not advised when there is pre-existing liver disease, and after starting a psychotropic agent in a patient with hepatic impairment, frequent liver function/lesion monitoring is advised. The authors carefully review the pharmacokinetic disturbances induced by end-stage liver disease and the potential of psychopharmacological agents for liver toxicity.

Keywords: Hepatic disease; Liver; Pharmacokinetics; Psychotropic drugs; Toxicity.

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Conflict of interest statement

Conflict-of-interest statement: The authors report no conflicts of interest.

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