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Acute hepatitis due to fluoxetine therapy
Q Cai1, M A Benson, T J Talbot
1Department of General Internal Medicine, Marshfield Clinic, Wis. 54449, USA.
Mayo Clinic Proceedings
|July 16, 1999
Summary
Fluoxetine can cause rare cases of acute hepatitis, though typically it only causes minor liver enzyme changes. Physicians should monitor for drug-induced liver injury and consider stopping fluoxetine if suspected.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Drug-Induced Liver Injury
Background:
- Fluoxetine-induced hepatotoxicity is often underestimated and not widely recognized.
- While generally considered minor, asymptomatic liver enzyme elevations occur in 0.5% of long-term users.
- Previous reports include three cases of fluoxetine-associated acute hepatitis.
Purpose of the Study:
- To report two additional cases of acute hepatitis potentially caused by fluoxetine.
- To increase awareness of fluoxetine-associated liver injury among healthcare professionals.
Main Methods:
- Case report detailing two patients experiencing acute hepatitis.
- Review of existing literature on fluoxetine-induced hepatotoxicity.
Main Results:
- Two new cases of acute hepatitis attributed to fluoxetine were identified.
- These cases add to the limited but significant evidence of fluoxetine's potential for severe liver injury.
Conclusions:
- Fluoxetine can cause acute hepatitis, contrary to its generally perceived minimal clinical importance.
- The exact mechanism remains unknown, but early drug discontinuation is advised if fluoxetine-associated hepatitis is suspected.