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Antidepressants use in Liver disease?
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FORUM FOR PSYCHIATRY RESIDENTS :: Psychiatry :: Psychiatry-Neurology-Psychology discussion :: Psycho-Pharmacology
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Antidepressants use in Liver disease?
Which antidepressant will you prefer in patient with liver disease/abnormal liver function test?
I don't have good source to answer this question.
Please contribute your experience and sources for this question.
Duloxetine (Cymbalta) is one that we should avoid (FDA warning).
Thanks
Re: Antidepressants use in Liver disease?
SSRI are the prefferd anti-depressants in liver disease.
Of the SSRIs, paroxetine prescribed at the lower end of the dose range seems to be the safest option. Citalopram in the lower dose range and fluoxetine at half the usual dose, or given on
alternate days, will have less sedative effects.
Sertraline and lofepramine are to be avoided
Advances in psychiatric treatment,Managing depression in physical illness,Siobhan MacHale,2002
MAO-I and nefazodone should be avoided
Of the SSRIs, paroxetine prescribed at the lower end of the dose range seems to be the safest option. Citalopram in the lower dose range and fluoxetine at half the usual dose, or given on
alternate days, will have less sedative effects.
Sertraline and lofepramine are to be avoided
Advances in psychiatric treatment,Managing depression in physical illness,Siobhan MacHale,2002
MAO-I and nefazodone should be avoided
adisuper- Posts : 28
Points : 32
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Join date : 2012-06-04
Re: Antidepressants use in Liver disease?
Imipramine: start with 25 mg/day and titrate slowly (weekly at most) if required
or
Paroxetine or citalopram: start at 10 mg if severe hepatic impairment. Titrate
slowly (if required) as above (but note increased risk of bleeding)
or
Paroxetine or citalopram: start at 10 mg if severe hepatic impairment. Titrate
slowly (if required) as above (but note increased risk of bleeding)
mentalist- Posts : 1
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Join date : 2014-07-15
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FORUM FOR PSYCHIATRY RESIDENTS :: Psychiatry :: Psychiatry-Neurology-Psychology discussion :: Psycho-Pharmacology
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