Psychotropic Drugs and Liver Disease: A Critical Review of Pharmacokinetics and Liver Toxicity

Overview

Journal World J Gastrointest Pharmacol Ther

Publisher Baishideng Publishing Group

Date 2017 Feb 21

PMID 28217372

Citations 37

Authors

Diogo Telles-Correia

Antonio Barbosa

Helena Cortez-Pinto

Carlos Campos

Nuno B F Rocha

Sergio Machado

Affiliations

Soon will be listed here.

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.

Citing Articles

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