Jaundice in Relation to Chlorpromazine Therapy

Isaacs, Bernard; Macarthur, J.; Taylor, Rhoda M.

doi:10.1136/bmj.2.4948.1122

Cited by 34 publications

(4 citation statements)

References 7 publications

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“…Another finding of our study consists of several identified signals, both for comprehensive search and for severe events, for the phenothiazines included in our study (perazine, perphenazine, fluphenazine, levomepromazine). Likewise, previous studies indicate considerable hepatotoxicity by some FGAs belonging to the group of phenothiazines with the most prominent example of jaundice occurring in the treatment with chlorpromazine 28–30 . Extensive hepatic metabolism might be a possible explanation for the risk of DILI associated with phenothiazines in our evaluation.…”

Section: Discussionsupporting

confidence: 62%

“…Likewise, previous studies indicate considerable hepatotoxicity by some FGAs belonging to the group of phenothiazines with the most prominent example of jaundice occurring in the treatment with chlorpromazine. [28][29][30] Extensive hepatic metabolism might be a possible explanation for the risk of DILI associated with phenothiazines in our evaluation. However, we also found a signal for amisulpride, which is not subject to an extensive hepatic metabolization.…”

Section: Current Scientific Literaturementioning

confidence: 99%

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Drug-Associated Liver Injury Related to Antipsychotics

Zeiss

Hafner

Schönfeldt‐Lecuona

et al. 2022

J Clin Psychopharmacol

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Background: Drug-associated liver injury is one of the most common causes for acute liver failure and market withdrawal of approved drugs. In addition, the potential for hepatotoxicity related to specific substances has to be considered in psychopharmacotherapy. However, systematic evaluations of hepatotoxicity related to antipsychotics are limited. Methods:We conducted an exploratory case/non-case study and evaluated pharmacovigilance data from VigiBase related to 30 antipsychotics marketed in the European Union. Reporting odds ratios were calculated for antipsychotics associated with the Standardized Medical Dictionary of Regulatory Activities queries "Drug-related hepatic disorders-comprehensive search" (DRHD-CS) and "Drug-related hepatic disorders-severe events only" (DRHD-SEO).Results: We found several signals for drug-associated liver injury including signals for severe events: 17 of 30 antipsychotics were associated with DRHD-CS and 10 of 30 antipsychotics with DRHD-SEO. Amisulpride, fluphenazine, levomepromazine, loxapine, olanzapine, perazine, perphenazine, pipamperone, sulpiride, and thioridazine were associated with both, DRHD-CS and DRHD-SEO. No association with fatal outcomes was detected.Conclusions: Several common antipsychotics are associated with hepatotoxicity, partly also with severe hepatotoxicity. Our data do not allow to account for patient-related risk factors for drug-associated liver injury. This should be addressed in further studies.

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Section: Discussionsupporting

confidence: 62%

Section: Current Scientific Literaturementioning

confidence: 99%

Drug-Associated Liver Injury Related to Antipsychotics

Zeiss

Hafner

Schönfeldt‐Lecuona

et al. 2022

J Clin Psychopharmacol

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“…Apparently this drug causes selective injury to the finer biliary radic1es with minimal parenchymal involvement, similar to the dam age resulting from methyltestosterone and thiouracil (206). There is no direct toxic action on the liver since there is no correlation between dosage and degree of jaundice (207). The incidence of jaundice appears to approximate one per cent, with clinical symptoms varying from pruritis alone to a syn drome of vague abdominal complaints, anorexia, nausea, vomiting, chills, rash, and fever to 102° (208,209).…”

Section: Viral Hepatitismentioning

confidence: 96%

Diseases of the Gastrointestinal Tract

Gray¹,

Krakauer²,

Ramsey³

et al. 1957

Annu. Rev. Med.

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“…Because the majority of atypical antipsychotics are relatively new, there still are no long-term hepatic follow-ups with some of these drugs. Therefore, new evidence might appear in longer controlled studies regarding the frequency of and risk factors for liver damage[ 108 ].…”

Section: Dilimentioning

confidence: 99%

Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity

Telles-Correia

Barbosa

Cortez‐Pinto

et al. 2017

WJGPT

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The liver is the organ by which the majority of substances are metabolized, including psychotropic drugs. There are several pharmacokinetic changes in end-stage liver disease that can interfere with the metabolization of psychotropic drugs. This fact is particularly true in drugs with extensive first-pass metabolism, highly protein bound drugs and drugs depending on phase I hepatic metabolic reactions. Psychopharmacological agents are also associated with a risk of hepatotoxicity. The evidence is insufficient for definite conclusions regarding the prevalence and severity of psychiatric drug-induced liver injury. High-risk psychotropics are not advised when there is pre-existing liver disease, and after starting a psychotropic agent in a patient with hepatic impairment, frequent liver function/lesion monitoring is advised. The authors carefully review the pharmacokinetic disturbances induced by end-stage liver disease and the potential of psychopharmacological agents for liver toxicity.

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Jaundice in Relation to Chlorpromazine Therapy

Cited by 34 publications

References 7 publications

Drug-Associated Liver Injury Related to Antipsychotics

Drug-Associated Liver Injury Related to Antipsychotics

Diseases of the Gastrointestinal Tract

Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity

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