Liver toxicity due to olanzapine

Domínguez-Jiménez, José Luis; Puente-Gutiérrez, Juan Jesús; Pelado-García, Eva María; Cuesta-Cubillas, Diego; García-Moreno, Antonio Manuel

doi:10.4321/s1130-01082012001100017

Cited by 14 publications

(6 citation statements)

References 2 publications

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“…In the case of our patient, we are unable to entirely exclude the fact that olanzapine may have also contributed to her liver injury as olanzapine also undergoes extensive hepatic metabolism by CYP1A2 and to a lesser extent by CYP2D6[11]. Olanzapine has also been reported to cause transient serum liver enzyme elevations[4].…”

Section: Discussionmentioning

confidence: 94%

“…Although olanzapine has also been linked to reports of DILI[4], it was precluded as a culprit drug in this case because the patient had previously taken it with no issues. She was treated with oral olanzapine 10 mg nightly and oral fluoxetine 20 mg every morning in February 2018 for psychotic depression, with good resolution of symptoms and the drugs were subsequently tapered and stopped by December 2018.…”

Section: Final Diagnosismentioning

confidence: 99%

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Escitalopram-induced liver injury: A case report and review of literature

Yong

Loke

et al. 2019

WJH

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BACKGROUNDDepression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5% of healthy years lost due to disability. Escitalopram, one of the first-line medications for the treatment of depression, is a selective serotonin reuptake inhibitor and one of the most commonly prescribed antidepressant medications worldwide. Although thought to be generally safe and with minimal drug-drug interactions, we herein present an unusual case of cholestatic liver injury, likely secondary to escitalopram initiation.CASE SUMMARYA 56-year-old Chinese lady presented with fever and cholestatic liver injury two weeks after initiation of escitalopram for the treatment of psychotic depression. Physical examination was unremarkable. Further investigations, including a computed tomography scan of the abdomen and pelvis and tests for hepatitis A, B and C and for autoimmune liver disease were unyielding. Hence, a diagnosis of escitalopram-induced liver injury was made. Upon stopping escitalopram, repeat liver function tests showed downtrending liver enzymes with eventual normalization of serum aspartate aminotransferase and alanine aminotransferase one-week post-discharge.CONCLUSIONClinicians should be aware of the possibility of escitalopram-induced liver injury when initiating depressed patients on antidepressant treatment. This requires extra vigilance as most patients may remain asymptomatic. Measurement of liver function tests could be considered after initiation of antidepressant treatment, especially in patients with pre-existing liver disease.

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Section: Discussionmentioning

confidence: 94%

Section: Final Diagnosismentioning

confidence: 99%

Escitalopram-induced liver injury: A case report and review of literature

Yong

Loke

et al. 2019

WJH

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“…In addition, it is related to signifi cant weight gain and metabolic alterations such as dyslipidemias, diabetes, and other problems involving the metabolic syndrome (2,3). There are few cases declaring OLZ associated hepatotoxicity in patients, but the mechanism that leads to OLZ-related liver toxicity is not well known (4). The primary site for OLZ metabolism is the liver, where it is metabolized into inactive metabolites primarily by the cytochrome P450 system.…”

Section: Introductionmentioning

confidence: 99%

The protective effect of thymoquinone over olanzapine-induced side effects in liver, and metabolic side effects

Bilğiç¹,

Korkmaz²,

Azırak³

et al. 2018

BLL

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OBJECTIVES: The aim of the study was to investigate the possible protective qualities of thymoquinone (TQ) against the side-effects of olanzapine (OLZ) in an experimental model in rat liver with histologic and biochemical assessments. METHODS: Experimental procedures were performed on 35 female Sprague Dawley rats. Rats were randomly divided into fi ve groups as: group 1: control; group 2: OLZ; group 3: OLZ+TQ-1; group 4: OLZ+TQ-2; and group 5: OLZ+TQ-3. RESULTS: The results showed that a 2-week administration of OLZ (4 mg/kg, once a day for the fi rst week, 8 mg/kg once a day for the second week, p.o.) and treatment with TQ (25, 50, 100 mg/kg, once daily, p.o.) signifi cantly reduced weight gain induced by OLZ. In addition, TQ increased the total antioxidant status (TAS), high-density lipoprotein cholesterol (HDL), insulin levels and decreased serum oxidative stress index (OSI), total oxidant status (TOS), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), low density lipoprotein cholesterol (LDL), glucose, triglycerides (TG) and total cholesterol (CH) levels signifi cantly (p < 0.05). CONCLUSION: This study revealed that treatment with TQ might protect liver tissue against the side-effects of OLZ. TQ could be an effective course of therapy to enhance therapeutic effi cacy (Tab. 4, Fig. 4, Ref. 47). Text in PDF www.elis.sk.

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“…Few side effects have been reported for Olanzapine, such as severe pruritic skin eruption [3]. Some investigators observed that Olanzapine induced hepatic toxicity in few cases [4]. Olanzapine induces weight gain, insulin resistance, hyperglycemia, and dyslipidemia [5].…”

Section: Introductionmentioning

confidence: 99%

Differential Expression of CD3, TNF-α, and VEGF Induced by Olanzapine on the Spleen of Adult Male Albino Rats and the Possible Protective Role of Vitamin C

Youssef

Salah

2019

Biomedicines

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Olanzapine is an antipsychotic drug effective in the treatment of stress-associated psychiatric illnesses, but its effect on the spleen remains unclear. Vitamin C is essential for the optimum function of the immune system. We aim to investigate the effect of Olanzapine on spleen structures and to assess the protective effect of vitamin C. Forty adult male albino rats were divided into four groups: group (I), a control; group (II), rats were given vitamin C at 40 mg/kg body weight; group (III), rats were given Olanzapine at 2 mg/kg body weight; and group (IV), rats were given vitamin C and Olanzapine at the same dose of group (II) and group (III) for one month. The hematoxylin and eosin (H&E) of the olanzapine treated group showed focal areas of cellular depletion and a decrease in the size of the white pulp. The red pulp was expanded and showed marked congestion and dilatation of blood sinusoids. Cluster of differentiation 3 (CD3) was significantly reduced, however both tumor necrosis factor alpha (TNF-α), and vascular endothelial growth factor (VEGF) were significantly higher. The administration of vitamin C repaired structural and immunohistochemical changes via increased CD3 and decreased TNF-α and VEGF. Therefore, the oxidative and the inflammatory pathways may be the possible mechanisms underlying olanzapine immunotoxicity. Vitamin C exerted immune modulator and antioxidant effects against olanzapine.

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Liver toxicity due to olanzapine

Cited by 14 publications

References 2 publications

Escitalopram-induced liver injury: A case report and review of literature

Escitalopram-induced liver injury: A case report and review of literature

The protective effect of thymoquinone over olanzapine-induced side effects in liver, and metabolic side effects

Differential Expression of CD3, TNF-α, and VEGF Induced by Olanzapine on the Spleen of Adult Male Albino Rats and the Possible Protective Role of Vitamin C

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