Relationship between depression and chronic liver disease: Potential role of antidepressants in modulating liver fibrosis

Depression is a frequent comorbidity in chronic liver disease (CLD), including Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), viral hepatitis, autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), hemochromatosis, and Wilson's disease. It is associated with worse outcomes, accelerated disease progression, increased hospitalizations, and higher mortality. While antidepressants are commonly prescribed, their effects on liver disease, particularly on liver fibrosis, remain underexplored. This narrative review examines the relationship between depression, CLD, and antidepressants through a literature review of studies published between 2010 and 2024. Some evidence suggests that antidepressants may have antifibrotic properties, as seen in pulmonary fibrosis, but liver-specific data are limited. Understanding their potential role in both mental health and liver disease management could improve patient outcomes. However, significant research gaps remain, and further clinical trials are needed to determine whether antidepressants influence liver fibrosis, disease progression, and overall prognosis in CLD.