| Antipsychotics and abnormal liver function tests: systematic review. | |
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MedLine Citation:
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PMID: 22986798 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Katie F M Marwick; Mark Taylor; Simon W Walker |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical neuropharmacology Volume: 35 ISSN: 1537-162X ISO Abbreviation: Clin Neuropharmacol Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-09-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7607910 Medline TA: Clin Neuropharmacol Country: United States |
Other Details:
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Languages: eng Pagination: 244-53 Citation Subset: IM |
Affiliation:
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*Division of Psychiatry, Kennedy Tower, and †Psychiatry, Royal Edinburgh Hospital; and ‡Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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