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Agomelatine-induced liver injury in a patient with choledocholithiasis

Published online by Cambridge University Press:  22 October 2014

Piotr Eder ,
Agnieszka Permoda-Osip ,
Przemyslaw Majewski ,
Krzysztof Linke  and
Janusz K. Rybakowski
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
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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.

Keywords

agomelatinecholelithiasisdepressionhepatotoxicity
Type
Case Report
Information
Acta Neuropsychiatrica , Volume 27 , Issue 1 , February 2015 , pp. 56 - 59
Copyright
© Scandinavian College of Neuropsychopharmacology 2014 

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