Reactions 1196 - 5 Apr 2008

SCitalopram

Liver injury: case reportA 56-year-old woman with no history of liver disease

developed acute liver injury, 3 weeks after initiating citalopram[Cipramil] 20 mg/day [therapeutic indication not stated]. Shepresented with asthenia, weight loss and jaundice. Onexamination she was noted to have a mild hepatomegaly, andan abdominal ultrasound indicated acute hepatitis. Her bloodshowed elevated levels of bilirubin (11 mg/dL), AST (5.7 µmol/s/L), ALT (14.2 µmol/s/L) and γ-glutamyltransferase (6.9 µmol/s/L). Histology performed on a biopsy was consistent with adrug-induced liver injury, with subacute liver dystrophy andhepatic necrosis. Citalopram was discontinued, and within3 months the woman’s serum liver function tests hadcompletely normalised.

Author comment: "The causal association can beestablished because there was a temporal relationshipbetween the drug administration and hepatic injury whichwas subsequently histologically confirmed. Furthermore, thepatient rapidly improved after administration of the drug wasstopped."Neumann H, et al. Drug-induced liver disease related to citalopram. Journal ofClinical Psychopharmacology 28: 254-255, No. 2, Apr 2008 -Germany 801103485

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Reactions 5 Apr 2008 No. 11960114-9954/10/1196-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved