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Cross hepatotoxicity between tricyclic antidepressants and phenothiazines
A J Remy1, D Larrey, G P Pageaux
1Department of Hepato-Gastroenterology, Saint-Eloi Hospital, Montpellier, France.
Objective:
To describe a case of cross hepatotoxicity between tricyclic antidepressants and phenothiazines.
Patient:
A woman who developed three episodes of drug-induced hepatitis within 3 years as a result of successive treatment with two tricyclic antidepressants, trimipramine and desipramine, and one neuroleptic derivative, cyamemazine.
Interventions:
The drugs were withdrawn after the patient experienced liver dysfunction, although bromazepam was later administered with no side effects.
Results:
After three episodes of drug-induced hepatitis the patient's serum aspartate aminotransferase and alanine aminotransferase levels returned to normal when the tricyclic antidepressants and cyamemazine were withdrawn.
Conclusions:
Trimipramine, desipramine and cyamemazine are related by their chemical structures which include a tricyclic ring. This suggests that this chemical moiety might be involved in the hepatotoxicity of tricyclic antidepressants and phenothiazine derivatives.