There are few published reports of antidepressive therapy induced hepatotoxicity.
In most cases antidepressants cause only slight elevation of liver enzymes without
clinical relevance. However, our patient with recidivation of unipolar depressive
disorder developed severe laboratory abnormalities and clinical symptoms during therapy
with maprotiline (Ludiomil®) and opipramol (Insidon®). To our knowledge, this is the
first case report of bioptically proven severe acute hepatitis caused by these antidepressants.
After their withdrawal, the patient's fatigue symptoms, scleric jaundice, and marked
increase of liver enzymes completely disappeared. Hepatic side effects should be considered
during antidepressive therapy with maprotiline and opipramol especially when additional
clinical symptoms emerge.
