Reactions 1010 - 17 Jul 2004

★Citalopram

First report of liver disorders: case reportA 44-year-old man receiving citalopram 20 mg/day for

depression presented with a 1-week history of asthenia andweight loss 8 weeks after starting treatment. He was alsoreceiving hydroxyzine and clonazepam. His physicalexamination was normal, but he had an AST level of 277 IU/L(normal < 30) and an ALT level of 1078 IU/L (< 36). Viralcauses were ruled out and he tested negative forautoantibodies. Citalopram was discontinued and, 5 dayslater, his AST level decreased by > 50%. All symptomsnormalised within 2 months.

Author comment: "A causal association betweencitalopram and hepatocellular injury can confidently beestablished because there was a temporal relationshipbetween the administration of the drug and the onset ofhepatic abnormalities, there was a rapid recovery afterstopping the drug, and alternative explanations were ruledout."Lopez-Torres E, et al. Hepatotoxicity related to citalopram. American Journal ofPsychiatry 161: 923-924, No. 5, May 2004 - Spain 800981207

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of liver disorders associatedwith citalopram. The WHO Adverse Drug Reactions databasecontained 62 reports of abnormal hepatic function, 47 reports ofhepatitis and 11 reports of hepatocellular damage associatedwith citalopram.

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Reactions 17 Jul 2004 No. 10100114-9954/10/1010-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved