Last month (December 2013) the American Journal of Psychiatry published Antidepressant-Induced Liver Injury: A Review for Clinicians, by Voican C.S. et al. The study was a literature search from 1965 onwards.
Here are the authors’ results:
- All antidepressants can induce hepatotoxicity, especially in elderly patients and those taking more than one drug
- Liver damage is generally unpredictable and unrelated to dose
- Liver damage can occur within a few days of initiation
- Antidepressant-induced liver failure can be life threatening
- Antidepressants with higher risk for liver failure include: iproniazid, nefazodone, phenelzine, imipramine, amitriptyline, duloxetine, bupropion, trazodone, tianeptine, and agomelatine
- Antidepressants with lower risk: citalopram, escitalopram, paroxetine, and fluvoxamine
- Although an infrequent event, antidepressant-induced liver injury may be irreversible