Acute Liver Failure due to Trazodone and Diazepam

Area of Science:

• Hepatology
• Pharmacology
• Clinical Medicine

Background:

• Antidepressant medications are widely prescribed but carry a risk of drug-induced liver injury (DILI).
• While generally rare, DILI from antidepressants can occur even at therapeutic doses.
• Idiopathic DILI lacks preventative measures, but early detection can mitigate severity.

Observation:

• A 63-year-old male developed acute liver failure after three months of trazodone and diazepam therapy.
• The patient was receiving standard therapeutic doses of both medications.
• The severe liver injury necessitated a liver transplant.

Findings:

• This case highlights a rare instance of severe DILI linked to trazodone and diazepam co-administration.
• The temporal relationship suggests a potential causal link between the medications and acute liver failure.
• Prompt recognition and intervention are critical for managing antidepressant-induced hepatotoxicity.

Implications:

• Physicians should maintain a high index of suspicion for DILI in patients on antidepressant therapy.
• Regular monitoring of liver function tests is recommended for individuals taking trazodone.
• Early identification and discontinuation of the offending agent are vital to prevent life-threatening outcomes.