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• W2056769228 abstract "Introduction: Depression is a common mental disorder, and is according to the World Health Organisation the second leading cause of disability in the world. The discovery of antidepressants and especially Selective Serotonin Recapture Inhibitors (SSRI) has been a major contribution in the treatment of the disease. Despite all the efforts made during the preclinical phase, the drug hepatotoxicity is revealed, most of the time, after their marketing. Hepatotoxicity of antidepressants has played a central role in guiding prescriptions and has been implicated in the decisions of removal from the market of certain molecules. The aim of our study was to estimate the prevalence of hepatotoxicity in patients with major depressive disorder treated with antidepressants and to estimate the most harmful antidepressants for the liver. Patients and Method: We conducted a comparative crosssectional study on patients with recurrent depressive disorder (according to the DSM IV text revised) treated with antidepressants. We included 122 outpatients followed in the psychiatry department of Fattouma Bourguiba Hospital of Monastir (Tunisia) and controls aged from 22 to 59 year old with no history of mental or physical illness. The two groups were paired in age and sex. The hepatotoxicity was assessed by seric assay of Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Direct Bilirubin (DB), Total Bilirubin (TB) Total cholesterol (TC), g-Glutamyltransferase (GGT), Alkaline Phosphatase (PAL) and triglyceride (TG). All chemical analyses were performed on Cobas 600TM (Roche Diagnostics) in the biochemical and toxicological laboratory of the Fattouma Bourguiba Hospital of Monastir. All the statistical analyses were performed with Statistical Package for the Social Sciences (SPSS) 18.0 for windows. Results: The mean age of our patients was 43.79±13.00 year old. The sex ratio was 0.67. Thirty-four per cent of our patients were treated by tricyclic antidepressants (TCA) and 66% were treated by SSRI. Compared with controls, our patients had higher activities of AST (p<10−3) and GGT (p = 0.001) and a higher total bilirubin concentration (p = 0.039). In addition, patients treated longer than one month had an increased activity of AST (p = 0.034) and PAL (p = 0.042). We etablished a significant positive correlation between triglycerides and activities of ALT (r= 0.227; p = 0.012) and PAL (r= 0.293; p = 0.001). The ALT activity was significantly higher in patients treated with TCA compared to those treated with the SSRI (p = 0.011). We observed an increase in ALT and AST activities in 4.7% of patients treated with TCA and 3.7% of patients treated with SSRI. The GGT activity was higher with clomipramine (p = 0.007). Conclusion: Antidepressant treatment is accompanied with higher activities of AST and GGT, higher concentration of TB. Tricyclics seem to be the most hepatoxic antidepressant drugs. All patients should have liver function tests before the initiation of a treatment with an antidepressant and regularly during treatment especially for treatment with TCA and an appropriate education." @default.
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• W2056769228 date "2014-10-01" @default.
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• W2056769228 title "P.2.b.027 Study of antidepressant hepatotoxicity in 122 Tunisian psychiatric outpatients" @default.
• W2056769228 doi "https://doi.org/10.1016/s0924-977x(14)70628-5" @default.
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