Braun J S, Geiger R, Wehner H, Schäffer S, Berger M
Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Germany.
Pharmacopsychiatry. 1998 Jul;31(4):152-5. doi: 10.1055/s-2007-979319.
There are few published reports of antidepressive therapy induced hepatotoxicity. In most cases antidepressants cause only slight elevation of liver enzymes without clinical relevance. However, our patient with recidivation of unipolar depressive disorder developed severe laboratory abnormalities and clinical symptoms during therapy with maprotiline (Ludiomil) and opipramol (Insidon). To our knowledge, this is the first case report of bioptically proven severe acute hepatitis caused by these antidepressants. After their withdrawal, the patient's fatigue symptoms, scleric jaundice, and marked increase of liver enzymes completely disappeared. Hepatic side effects should be considered during antidepressive therapy with maprotiline and opipramol especially when additional clinical symptoms emerge.
关于抗抑郁治疗引起肝毒性的已发表报告很少。在大多数情况下，抗抑郁药只会导致肝酶轻微升高，并无临床意义。然而，我们的这位单相抑郁症复发患者在使用马普替林（路滴美）和奥匹哌醇（因息顿）治疗期间出现了严重的实验室异常和临床症状。据我们所知，这是首例经活检证实由这些抗抑郁药引起的严重急性肝炎的病例报告。停用这些药物后，患者的乏力症状、巩膜黄疸及肝酶显著升高完全消失。在用马普替林和奥匹哌醇进行抗抑郁治疗时，尤其是出现其他临床症状时，应考虑肝脏副作用。
