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Hepatotoxicity after short-term trazodone therapy
1School of Pharmacy, University of Connecticut, St. Francis Hospital Burgdorf Primary Care Clinic, Hartford, CT, USA. k.rettman@att.net
The Annals of Pharmacotherapy
|January 17, 2002
Summary
Severe liver damage (hepatotoxicity) occurred in a patient taking trazodone for only four days. This case highlights the risk of drug-induced hepatitis, even with short-term use, especially in patients with pre-existing liver conditions.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Toxicology
Background:
- A 46-year-old HIV-positive male with a history of intravenous drug abuse and hepatitis C was admitted for cocaine withdrawal.
- He was on a standard detoxification protocol including methadone, clonidine, and trazodone.
Observation:
- The patient developed acute hepatitis and cholestasis five days after admission.
- Liver function tests showed significant abnormalities, prompting discontinuation of trazodone and clonidine.
Findings:
- Liver enzymes improved dramatically within 10 days of discontinuing trazodone and clonidine.
- This is the first reported case of trazodone-induced liver damage after only a few days of therapy, distinguishing it from previous reports of hepatitis after weeks to months of use.
Implications:
- This case suggests trazodone can cause acute hepatitis even with short-term use (4 days at 200 mg/d).
- Healthcare providers should exercise caution and monitor liver function closely in patients with risk factors for liver damage, especially when prescribing trazodone.