Renemane Lubova, Rancans Elmars
Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia.
Riga Centre of Psychiatry and Addiction Disorders, Riga, Latvia.
Front Psychiatry. 2024 Aug 1;15:1456455. doi: 10.3389/fpsyt.2024.1456455. eCollection 2024.
This case report describes a patient with major depressive disorder (MDD) who developed acute hepatocellular liver injury after being treated with sertraline, a selective serotonin reuptake inhibitor (SSRI). The diagnosis of MDD was made two years prior, and the patient had previously responded partially to escitalopram and cognitive-behavioral therapy (CBT). Upon switching to sertraline 50 mg daily, the patient presented with severe symptoms indicative of acute liver injury, including elevated liver enzymes, jaundice, and gastrointestinal distress. Following the discontinuation of sertraline, the patient's liver function tests gradually normalized over a 90-day period, confirming the diagnosis of sertraline-induced hepatotoxicity. This case underscores the importance of continuous monitoring for potential liver injury in patients treated with sertraline. The findings contribute to the existing body of evidence on the hepatotoxic risks associated with SSRIs and highlight the need for personalized treatment strategies to mitigate adverse effects and enhance patient safety. Further research is needed to explore the long-term safety and efficacy of sertraline, particularly in vulnerable populations.
本病例报告描述了一名患有重度抑郁症(MDD)的患者,在接受选择性5-羟色胺再摄取抑制剂(SSRI)舍曲林治疗后发生急性肝细胞肝损伤。MDD诊断于两年前作出,该患者此前对艾司西酞普兰和认知行为疗法(CBT)部分有反应。在换用每日50毫克舍曲林后,患者出现了提示急性肝损伤的严重症状,包括肝酶升高、黄疸和胃肠道不适。停用舍曲林后,患者的肝功能检查在90天内逐渐恢复正常,确诊为舍曲林诱导的肝毒性。本病例强调了在接受舍曲林治疗的患者中持续监测潜在肝损伤的重要性。这些发现为现有的关于SSRI相关肝毒性风险的证据做出了贡献,并突出了需要个性化治疗策略以减轻不良反应并提高患者安全性。需要进一步研究以探索舍曲林的长期安全性和有效性,特别是在易感人群中。