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Telles-Correia D, Barbosa A, Cortez-Pinto H, et al. Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity. World J Gastrointest Pharmacol Ther. 2017;8(1):26-38doi: 10.4292/wjgpt.v8.i1.26.
Telles-Correia, D., Barbosa, A., Cortez-Pinto, H., Campos, C., Rocha, N. B., & Machado, S. (2017). Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity. World journal of gastrointestinal pharmacology and therapeutics, 8(1), 26-38. https://doi.org/10.4292/wjgpt.v8.i1.26
Telles-Correia, Diogo, et al. "Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity." World journal of gastrointestinal pharmacology and therapeutics vol. 8,1 (2017): 26-38. doi: https://doi.org/10.4292/wjgpt.v8.i1.26
Telles-Correia D, Barbosa A, Cortez-Pinto H, Campos C, Rocha NB, Machado S. Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity. World J Gastrointest Pharmacol Ther. 2017 Feb 06;8(1):26-38. doi: 10.4292/wjgpt.v8.i1.26. PMID: 28217372; PMCID: PMC5292604.
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World J Gastrointest Pharmacol Ther. 2017 Feb 06;8(1):26-38. doi: 10.4292/wjgpt.v8.i1.26.

Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity.

World journal of gastrointestinal pharmacology and therapeutics

Diogo Telles-Correia, António Barbosa, Helena Cortez-Pinto, Carlos Campos, Nuno B F Rocha, Sérgio Machado

Affiliations

  1. Diogo Telles-Correia, António Barbosa, Helena Cortez-Pinto, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal.

PMID: 28217372 PMCID: PMC5292604 DOI: 10.4292/wjgpt.v8.i1.26

Abstract

The liver is the organ by which the majority of substances are metabolized, including psychotropic drugs. There are several pharmacokinetic changes in end-stage liver disease that can interfere with the metabolization of psychotropic drugs. This fact is particularly true in drugs with extensive first-pass metabolism, highly protein bound drugs and drugs depending on phase I hepatic metabolic reactions. Psychopharmacological agents are also associated with a risk of hepatotoxicity. The evidence is insufficient for definite conclusions regarding the prevalence and severity of psychiatric drug-induced liver injury. High-risk psychotropics are not advised when there is pre-existing liver disease, and after starting a psychotropic agent in a patient with hepatic impairment, frequent liver function/lesion monitoring is advised. The authors carefully review the pharmacokinetic disturbances induced by end-stage liver disease and the potential of psychopharmacological agents for liver toxicity.

Keywords: Hepatic disease; Liver; Pharmacokinetics; Psychotropic drugs; Toxicity

Conflict of interest statement

Conflict-of-interest statement: The authors report no conflicts of interest.

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