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Related Experiment Videos

Risperidone- and quetiapine-induced cholestasis.

Tara M Wright¹, Amy M Vandenberg

¹Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA. wright@musc.edu

The Annals of Pharmacotherapy

|August 2, 2007

Summary

This case study highlights a rare instance of drug-induced cholestasis in a patient on long-term risperidone therapy, which recurred with quetiapine. Early patient education on hepatotoxicity signs is crucial for managing this rare antipsychotic side effect.

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Area of Science:

Hepatology
Pharmacology
Psychiatry

Background:

Atypical antipsychotics are widely used for psychiatric disorders.
While generally safe, they can rarely cause liver injury, including cholestasis.
Long-term adverse effects are less commonly reported.

Observation:

A 30-year-old male with schizoaffective disorder developed cholestasis after 8 years of risperidone.
Cholestasis resolved upon risperidone discontinuation and recurred with quetiapine initiation.
The Naranjo scale confirmed probable causality for both risperidone and quetiapine.

Findings:

This is the first reported case of cholestasis developing after years of antipsychotic treatment and reappearing with a different agent.
Atypical antipsychotic-induced liver injury, particularly cholestatic type, is rare.
The patient tolerated ziprasidone and olanzapine without adverse events.

Implications:

Patient education on early warning signs of drug-induced liver injury is essential.
Early detection can facilitate timely intervention, potentially preventing severe outcomes.
This case underscores the importance of monitoring for rare but serious adverse effects of antipsychotics.