Document Detail

Antipsychotics and abnormal liver function tests: systematic review.
MedLine Citation:
PMID:  22986798     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Systematic assessment of the prevalence and pattern of liver function test (LFT) abnormalities associated with regular antipsychotics in adult humans and consideration of management of such abnormalities.
DATA SOURCES: Systematic search identifying cohort, cross-sectional or case studies/series, reporting LFT abnormalities in patients receiving regular antipsychotics. EMBASE, PsychINFO, and MEDLINE were searched for studies in English from record onset.
STUDY SELECTION: Abstracts were independently screened for eligibility by 2 researchers. Ineligible studies included those that did not report LFT reference ranges, those that studied fewer than 10 patients on a given antipsychotic, and those studying children.
DATA EXTRACTION: Key variables in group studies were extracted. Case studies/series were examined for patient outcome.
DATA SYNTHESIS: Ten group studies and 91 case studies/series were eligible, although quality was poor. All groups receiving regular antipsychotics had a prevalence of LFT abnormalities greater than chance. The median percentage of patients with any abnormal LFT on any antipsychotic was 32%, with a range of 5% to 78%. The median percentage of patients with clinically significant elevations was 4%, with a range of 0% to 15%. Transaminases were most commonly elevated. Abnormalities were generally asymptomatic, arose within 6 weeks, and were either stably persistent or resolved with continued treatment. Case reports suggested that antipsychotics can be associated with severe hepatitis, fatal in a small minority of cases. Chlorpromazine is most commonly associated with acute liver injury.
CONCLUSIONS: The LFT abnormalities in patients receiving regular antipsychotics are common but generally mild and transient. Very rarely, a severe or fatal hepatic injury can emerge.
Katie F M Marwick; Mark Taylor; Simon W Walker
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical neuropharmacology     Volume:  35     ISSN:  1537-162X     ISO Abbreviation:  Clin Neuropharmacol     Publication Date:    2012 Sep-Oct
Date Detail:
Created Date:  2012-09-18     Completed Date:  2013-07-09     Revised Date:  2013-07-17    
Medline Journal Info:
Nlm Unique ID:  7607910     Medline TA:  Clin Neuropharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  244-53     Citation Subset:  IM    
Division of Psychiatry, Kennedy Tower, Royal Infirmary of Edinburgh, Edinburgh, UK.
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MeSH Terms
Antipsychotic Agents / adverse effects*
Cohort Studies
Cross-Sectional Studies
Drug-Induced Liver Injury / diagnosis*,  epidemiology*
Liver Function Tests / methods
Reg. No./Substance:
0/Antipsychotic Agents
Comment In:
Clin Neuropharmacol. 2012 Nov-Dec;35(6):297-8   [PMID:  23151471 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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