For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
22
views
174
references
 Top references
cited by
30
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      560
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          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.

          Related collections

          Most cited references174

          • Record: found
          • Abstract: found
          • Article: not found

          Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period.

          Ramon Planas, Joan Costa, Aina Soler … (2005)
          Progress in the understanding of susceptibility factors to drug-induced liver injury (DILI) and outcome predictability are hampered by the lack of systematic programs to detect bona fide cases. A cooperative network was created in 1994 in Spain to identify all suspicions of DILI following a prospective structured report form. The liver damage was characterized according to hepatocellular, cholestatic, and mixed laboratory criteria and to histologic criteria when available. Further evaluation of causality assessment was centrally performed. Since April 1994 to August 2004, 461 out of 570 submitted cases, involving 505 drugs, were deemed to be related to DILI. The antiinfective group of drugs was the more frequently incriminated, amoxicillin-clavulanate accounting for the 12.8% of the whole series. The hepatocellular pattern of damage was the most common (58%), was inversely correlated with age (P < .0001), and had the worst outcome (Cox regression, P < .034). Indeed, the incidence of liver transplantation and death in this group was 11.7% if patients had jaundice at presentation, whereas the corresponding figure was 3.8% in nonjaundiced patients (P < .04). Factors associated with the development of fulminant hepatic failure were female sex (OR = 25; 95% CI: 4.1-151; P < .0001), hepatocellular damage (OR = 7.9; 95% CI: 1.6-37; P < .009), and higher baseline plasma bilirubin value (OR = 1.15; 95% CI: 1.09-1.22; P < .0001). Patients with drug-induced hepatocellular jaundice have 11.7% chance of progressing to death or transplantation. Amoxicillin-clavulanate stands out as the most common drug related to DILI.
          Article 0 comments Cited 202 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Idiosyncratic drug hepatotoxicity.

            Neil Kaplowitz (2005)
            The occurrence of idiosyncratic drug hepatotoxicity is a major problem in all phases of clinical drug development and the most frequent cause of post-marketing warnings and withdrawals. This review examines the clinical signatures of this problem, signals predictive of its occurrence (particularly of more frequent, reversible, low-grade injury) and the role of monitoring in prevention by examining several recent examples (for example, troglitazone). In addition, the failure of preclinical toxicology to predict idiosyncratic reactions, and what can be done to improve this problem, is discussed. Finally, our current understanding of the pathophysiology of experimental drug hepatotoxicity is examined, focusing on acetaminophen, particularly with respect to the role of the innate immune system and control of cell-death pathways, which might provide targets for exploration and identification of risk factors and mechanisms in humans.
            Article 0 comments Cited 180 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Hepatic Histological Findings in Suspected Drug-Induced Liver Injury: Systematic Evaluation and Clinical Associations

              David Kleiner, Naga P Chalasani, William Lee … (2013)
              Drug-induced liver injury (DILI) is considered to be a diagnosis of exclusion. Liver biopsy may contribute to diagnostic accuracy, but the histological features of DILI and their relationship to biochemical parameters and outcomes are not well defined. We have classified the pathological pattern of liver injury and systematically evaluated histological changes in liver biopsies obtained from 249 patients with suspected DILI enrolled in the prospective, observational study conducted by the Drug Induced Liver Injury Network. Histological features were analyzed for their frequency within different clinical phenotypes of liver injury and to identify associations between clinical and laboratory findings and histological features. The most common histological patterns were acute (21%) and chronic hepatitis (14%), acute (9%) and chronic cholestasis (10%), and cholestatic hepatitis (29%). Liver histology from 128 patients presenting with hepatocellular injury had more severe inflammation, necrosis, and apoptosis and more frequently demonstrated lobular disarray, rosette formation, and hemorrhage than those with cholestasis. Conversely, histology of the 73 patients with cholestatic injury more often demonstrated bile plugs and duct paucity. Severe or fatal hepatic injury in 46 patients was associated with higher degrees of necrosis, fibrosis stage, microvesicular steatosis, and ductular reaction among other findings, whereas eosinophils and granulomas were found more often in those with milder injury. Conclusion: We describe an approach for evaluating liver histology in DILI and demonstrate numerous associations between pathological findings and clinical presentations that may serve as a foundation for future studies correlating DILI pathology with its causality and outcome. (Hepatology 2014;59:661–670)
              Article 0 comments Cited 116 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): World J Gastrointest Pharmacol Ther
                Journal ID (publisher-id): WJGPT
                Title: World Journal of Gastrointestinal Pharmacology and Therapeutics
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 2150-5349
                Publication date (Print): 6 February 2017
                Publication date (Electronic): 6 February 2017
                Volume: 8
                Issue: 1
                Pages: 26-38
                Affiliations
                Diogo Telles-Correia, António Barbosa, Helena Cortez-Pinto, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
                Carlos Campos, Sérgio Machado, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
                Nuno B F Rocha, School of Health Technologies, Polytechnic Institute of Porto, 4169-007, Porto, Portugal
                Sérgio Machado, Postgraduate Program of Physical Activity Sciences, Salgado de Oliveira University, Niterói 24030-060, Brazil
                Author notes

                Author contributions: Telles-Correia D, Barbosa A and Cortez-Pinto H contributed equally to this work; Telles-Correia D, Barbosa A, Cortez-Pinto H, Campos C, Rocha NBF and Machado S designed the study; Telles-Correia D, Barbosa A, Cortez-Pinto H and Rocha NBF wrote the paper.

                Correspondence to: Dr. Diogo Telles-Correia, Faculty of Medicine, University of Lisbon, A.v. Padre Cruz, 1649-028 Lisbon, Portugal. tellesdiogo@ 123456gmail.com

                Telephone: +351-21-7985100 Fax: +351-21-7985112

                Article
                Other ID: jWJGPT.v8.i1.pg26
                DOI: 10.4292/wjgpt.v8.i1.26
                PMC ID: 5292604
                PubMed ID: 28217372
                SO-VID: 0bbd0d0d-4bc2-46c5-bfe6-49c3133c67a9
                Copyright © ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date received : 2 June 2016
                Date revision received : 2 November 2016
                Date accepted : 16 November 2016
                Categories
                Subject: Review

                Keywords: liver,toxicity,psychotropic drugs,pharmacokinetics,hepatic disease
                Data availability:
                Keywords: liver, toxicity, psychotropic drugs, pharmacokinetics, hepatic disease

                Comments

                Comment on this article

                scite_

                Similar content560

                See all similar

                Cited by30

                See all cited by

                Most referenced authors1,234

                See all reference authors