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Related Experiment Videos

Hepatic failure associated with imipramine therapy.

M S Shaefer1, A L Edmunds, R S Markin

  • 1Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha.

Pharmacotherapy
|January 1, 1990
PubMed
Summary

Imipramine, an antidepressant, rarely causes liver issues, usually mild and reversible. However, one case showed severe liver failure in a child treated for enuresis, requiring a transplant.

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Area of Science:

  • Hepatology
  • Clinical Pharmacology
  • Pediatric Gastroenterology

Background:

  • Imipramine is a tricyclic antidepressant with a known, though rare, risk of hepatic abnormalities.
  • Most reported cases of imipramine-induced liver injury are mild and reversible upon drug cessation.

Observation:

  • An 11-year-old boy was treated with imipramine for nocturnal enuresis.
  • The patient developed severe liver injury, characterized by massive hepatocellular necrosis.

Findings:

  • The patient experienced fulminant hepatic failure following imipramine treatment.
  • This severe liver damage necessitated a liver transplant for survival.

Implications:

  • This case highlights a rare but potentially devastating hepatotoxic effect of imipramine, even in pediatric patients.

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  • Clinicians should maintain a high index of suspicion for severe liver injury in patients, particularly children, treated with imipramine, and consider alternative therapies if enuresis management is challenging.