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Agomelatine-induced liver injury in a patient with choledocholithiasis

Published online by Cambridge University Press:  22 October 2014

Piotr Eder
Affiliation:
Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
Agnieszka Permoda-Osip
Affiliation:
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
Przemyslaw Majewski
Affiliation:
Department of Clinical Pathomorphology, Poznan University of Medical Sciences, Poznan, Poland
Krzysztof Linke
Affiliation:
Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
Janusz K. Rybakowski*
Affiliation:
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
*
Janusz K. Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences,ul.Szpitalna 27/33, 60–572 Poznan, Poland. Tel: +4 861 847 5087; Fax: +4 861 848 0392; E-mail: janusz.rybakowski@gmail.com

Abstract

Objective

A case of agomelatine-induced hepatotoxicity is described in a 47-year female patient who has received the drug, 25 mg/day, for 4 months, for the treatment of depression.

Methods

The patient was admitted to the Department of Gastroenterology because of fatigue and nausea, with concomitant elevation of alanine aminotransferase (ALT), 550 U/L, and asparagine aminotransferase (AST), 300 U/L.

Results

Liver biopsy showed diffuse lymphocyte infiltration in the dilated portal spaces without lesion of hepatic lobules. Several weeks after stopping agomelatine, the liver enzymes returned to normal. Subsequently, small gallstones in common bile duct were detected and removed by the endoscopic sphincterotomy.

Conclusions

It is hypothesized that choledocholithiasis could theoretically increase a risk of developing agomelatine-induced hepatotoxicity in this patient. Any pre-existing liver disease should be a contraindication for treatment with agomelatine.

Type
Case Report
Copyright
© Scandinavian College of Neuropsychopharmacology 2014 

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References

1.Suk, KT, Kim, DJ. Drug-induced liver injury: present and future. Clin Mol Hepatol 2012;18:249257.Google Scholar
2.Voican, CS, Corruble, E, Naveau, S, Perlemuter, G. Antidepressant-induced liver injury: a review for clinicians. Am J Psychiatry 2014;171:404415.CrossRefGoogle ScholarPubMed
3.Agomelatine (Valdoxan/Thymanax): risk of dose-related hepatotoxicity and liver failure – updated warnings and monitoring guidance. Drug Safety Update 2013;6:A1.Google Scholar
4.Gahr, M, Freudenmann, RW, Connemann, BJ, Hiemke, C, Schonfeldt-Lecuona, C. Agomelatine and hepatotoxicity: implications of cumulated data derived from spontaneous reports of adverse drug reactions. Pharmacopsychiatry 2013;46:214220.Google Scholar
5.Karakus, E, Halici, Z, Albayrak, Aet al. Agomelatine: an antidepressant with new potent hepatoprotective effects on paracetamol-induced liver damage in rats. Hum Exp Toxicol 2013;32:846857.Google Scholar
6.Valoxan/Thymanax. European Medicines Agency (EMA) 2013;702809:3/73.Google Scholar
7.Czaja, AJ, Freese, DK. Diagnosis and treatment of autoimmune hepatitis. Hepatology 2002;36:479497.Google Scholar
8.Pisetsky, DS. Antinuclear antibodies in healthy people: the tip of auto autoimmunity’s iceberg? Arthritis Res Ther 2011;13:109.Google Scholar
9.Xindao, Y, Liping, W, Lingquan, L, Taisheng, Z, Qianzhi, W, Jianping, G. The role of combining MR cholangiopancreatography and T1W imaging in detecting common bile duct micro-stones. Indian J Radiol Imaging 2007;17:242246.Google Scholar
10.Venneman, NG, van Erpecum, KJ. Pathogenesis of gallstones. Gastroenterol Clin N Am 2010;39:171183.Google Scholar
11.Stuhes, M. Agomelatine-induced hepatotoxicity. Wien Klin Wochenschr 2013;125:225226.Google Scholar