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Aripiprazole-induced Hepatitis: A Case Report.

Lígia Castanheira1, Elsa Fernandes1, Pedro Levy1

  • 1Department of Psychiatry, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Portugal.

Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology
|November 2, 2019
PubMed
Summary

Aripiprazole, an atypical antipsychotic, was linked to a rare case of drug-induced liver injury in a young woman with first-episode psychosis. Symptoms resolved after discontinuing aripiprazole and initiating paliperidone.

Keywords:
AripiprazoleFirst-episode psychosisHepatitis.PsychosisTransaminases

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Area of Science:

  • Pharmacology
  • Hepatology
  • Psychiatry

Background:

  • Aripiprazole is an atypical antipsychotic used for schizophrenia and bipolar disorder.
  • Antipsychotic medications have a 32% prevalence of abnormal liver function tests.
  • Aripiprazole is generally well-tolerated with few reported side effects, and no prior cases of aripiprazole-induced liver injury have been published.

Purpose of the Study:

  • To report a rare case of drug-induced liver injury potentially associated with aripiprazole use.
  • To highlight the importance of monitoring liver function in patients treated with atypical antipsychotics.

Main Methods:

  • A case study of a 28-year-old female patient with first-episode psychosis treated with aripiprazole.
  • Clinical observation and laboratory analysis of liver function tests (ALT, AST, ALP, GGT, bilirubin).
  • Discontinuation of aripiprazole and initiation of paliperidone for treatment.

Main Results:

  • The patient developed jaundice, nausea, and vomiting nine days after increasing aripiprazole dosage.
  • Laboratory tests revealed significantly elevated liver enzymes and bilirubin levels.
  • Discontinuation of aripiprazole and commencement of paliperidone led to improvement in clinical symptoms and liver function.

Conclusions:

  • This case suggests a potential link between aripiprazole and drug-induced liver injury.
  • Close monitoring of liver function is crucial for patients receiving antipsychotic treatment.
  • Paliperidone may be a suitable alternative in cases of suspected antipsychotic-induced hepatotoxicity.