Severe drug-induced liver injury in patients under treatment with antipsychotic drugs: Data from the AMSP study.
World J Biol Psychiatry
; 22(5): 373-386, 2021 06.
Article
em En
| MEDLINE
| ID: mdl-32892689
ABSTRACT
OBJECTIVES:
Drug-induced liver injury (DILI) has been associated with various antipsychotic drugs (APDs). Comparative studies between individual APDs are largely not available.METHODS:
Antipsychotic drug utilisation data and reports of severe antipsychotic DILI were assessed by using data from an observational pharmacovigilance programme-Arzneimittelsicherheit in der Psychiatrie (AMSP)-during the period 1993-2016.RESULTS:
Of the 333,175 patients treated with APDs, a total of 246 (0.07%) events of severe DILI were identified. Phenothiazines were associated with significantly higher rates of severe DILI (0.03%, 95% CI = 0.02-0.04) than thioxanthenes (0.01%, 95% CI = 0.00-0.02) or butyrophenones (0.01%, 95% CI = 0.00-0.01). Among individual drugs, olanzapine (0.12%, 95% CI = 0.10-0.16), perazine (0.09%, 95% CI = 0.05-0.15) and clozapine (0.09%, 95% CI = 0.10-0.12 ranked highest. In 78 cases (31.7%), combination therapies with antipsychotic and antidepressant drugs or with two or more APDs were considered responsible. Male sex and a diagnosis of mania were associated with significantly higher rates of severe DILI while older patients (≥65 years old) were significantly less often affected.CONCLUSIONS:
In the present analysis of a representative psychiatric inpatient cohort, olanzapine, perazine, and clozapine were the most common individual APDs associated with severe DILI.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Antipsicóticos
/
Clozapina
/
Doença Hepática Induzida por Substâncias e Drogas
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article