Remy A J, Larrey D, Pageaux G P, Ribstein J, Ramos J, Michel H
Department of Hepato-Gastroenterology, Saint-Eloi Hospital, Montpellier, France.
Eur J Gastroenterol Hepatol. 1995 Apr;7(4):373-6.
To describe a case of cross hepatotoxicity between tricyclic antidepressants and phenothiazines.
A woman who developed three episodes of drug-induced hepatitis within 3 years as a result of successive treatment with two tricyclic antidepressants, trimipramine and desipramine, and one neuroleptic derivative, cyamemazine.
The drugs were withdrawn after the patient experienced liver dysfunction, although bromazepam was later administered with no side effects.
After three episodes of drug-induced hepatitis the patient's serum aspartate aminotransferase and alanine aminotransferase levels returned to normal when the tricyclic antidepressants and cyamemazine were withdrawn.
Trimipramine, desipramine and cyamemazine are related by their chemical structures which include a tricyclic ring. This suggests that this chemical moiety might be involved in the hepatotoxicity of tricyclic antidepressants and phenothiazine derivatives.
描述一例三环类抗抑郁药与吩噻嗪类药物之间的交叉肝毒性病例。
一名女性，因先后使用两种三环类抗抑郁药（曲米帕明和地昔帕明）及一种抗精神病药衍生物（氰美马嗪），在3年内发生了3次药物性肝炎。
患者出现肝功能障碍后停用了这些药物，不过后来使用溴西泮未出现副作用。
在发生3次药物性肝炎后，停用三环类抗抑郁药和氰美马嗪后，患者的血清天冬氨酸氨基转移酶和丙氨酸氨基转移酶水平恢复正常。
曲米帕明、地昔帕明和氰美马嗪因其化学结构中均包含三环而相关。这表明该化学基团可能与三环类抗抑郁药和吩噻嗪衍生物的肝毒性有关。
