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Case Reports
. 2017 Jan;24(1):40-42.
doi: 10.1159/000450878. Epub 2016 Nov 16.

Acute Liver Failure due to Trazodone and Diazepam

Sofia Carvalhana  1 , Ana Oliveira  2 , Pedro Ferreira  2 , Margarida Resende  2 , Rui Perdigoto  3 , Eduardo Barroso  3
Affiliations
Case Reports

Acute Liver Failure due to Trazodone and Diazepam

Sofia Carvalhana et al. GE Port J Gastroenterol. 2017 Jan.

Abstract
in English, Portuguese

Most antidepressant agents have the potential to cause liver injury, even at therapeutic doses. Nevertheless, drug-induced liver injury (DILI) from antidepressant agents is a rare event. There is no way to prevent idiopathic DILI, but the severity of the reaction may be minimized with prompt recognition and early withdrawal of the agent. We describe a rare case of a 63-year-old man presenting with acute liver failure after 3 months of trazodone and diazepam administration at normal therapeutic doses, requiring liver transplantation. This report should increase physicians' awareness of this complication and call attention to the regular monitoring of liver tests in patients taking trazodone, in order to prevent life-threatening complications.

A maioria dos antidepressivos tem o potencial de causar lesão hepática, mesmo em doses terapêuticas. Contudo, a hepatite tóxica por antidepressivos é um evento raro. Não existe forma de prevenir a hepatite tóxica, mas a sua gravidade pode ser minimizada com o diagnóstico precoce e a retirada antecipada do fármaco. Apresentamos um caso raro de um homem de 63 anos com insuficiência hepática aguda após 3 meses de terapêutica com trazodona e diazepam em doses terapêuticas, com necessidade de transplante hepático. Com este caso pretende-se alertar os clínicos para a possibilidade desta entidade e da necessidade de monitorização regular das provas hepáticas em doentes sob tratamento com trazodona, de forma a prevenir morbilidade e mortalidade.

Keywords: Antidepressive agents; Diazepam; Liver failure, acute/chemically induced; Trazodone.

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Figures

Fig. 1
Fig. 1
Photomicrographs of liver biopsy in hematoxylin and eosin staining showing confluent necrosis involving most of the liver parenchyma (a, magnification ×40), modest inflammation and evidence of feathery degeneration and ballooning of hepatocytes in parenchyma (b, ×400), and intrahepatic cholestasis (c, ×400).
See this image and copyright information in PMC

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