Severe drug-induced liver injury in patients under treatment with antipsychotic drugs: Data from the AMSP study

Druschky K, Toto S, Bleich S, Baumgaertner J, Engel RR, Grohmann R, Maier HB, Neyazi A, Rudolph YJ, Ruether E, Schwoerer H, Seifert J, Stuebner S, Degner D (2020)

Publication Type: Journal article

Publication year: 2020

Journal

World Journal of Biological Psychiatry Informa Healthcare

DOI: 10.1080/15622975.2020.1819565

Abstract

Objectives Drug-induced liver injury (DILI) has been associated with various antipsychotic drugs (APDs). Comparative studies between individual APDs are largely not available. Methods Antipsychotic drug utilisation data and reports of severe antipsychotic DILI were assessed by using data from an observational pharmacovigilance programme-Arzneimittelsicherheit in der Psychiatrie (AMSP)-during the period 1993-2016. Results Of the 333,175 patients treated with APDs, a total of 246 (0.07%) events of severe DILI were identified. Phenothiazines were associated with significantly higher rates of severe DILI (0.03%, 95% CI = 0.02-0.04) than thioxanthenes (0.01%, 95% CI = 0.00-0.02) or butyrophenones (0.01%, 95% CI = 0.00-0.01). Among individual drugs, olanzapine (0.12%, 95% CI = 0.10-0.16), perazine (0.09%, 95% CI = 0.05-0.15) and clozapine (0.09%, 95% CI = 0.10-0.12 ranked highest. In 78 cases (31.7%), combination therapies with antipsychotic and antidepressant drugs or with two or more APDs were considered responsible. Male sex and a diagnosis of mania were associated with significantly higher rates of severe DILI while older patients (>= 65 years old) were significantly less often affected. Conclusions In the present analysis of a representative psychiatric inpatient cohort, olanzapine, perazine, and clozapine were the most common individual APDs associated with severe DILI.

Authors with CRIS profile

Katrin Druschky Medizinische Fakultät

Additional Organisation(s)

Department of Neurology

Involved external institutions

Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Georg-August-Universität Göttingen DE Germany (DE) Universität Augsburg DE Germany (DE) Ludwig-Maximilians-Universität (LMU) DE Germany (DE)

How to cite

APA:

Druschky, K., Toto, S., Bleich, S., Baumgaertner, J., Engel, R.R., Grohmann, R.,... Degner, D. (2020). Severe drug-induced liver injury in patients under treatment with antipsychotic drugs: Data from the AMSP study. World Journal of Biological Psychiatry. https://doi.org/10.1080/15622975.2020.1819565

MLA:

Druschky, Katrin, et al. "Severe drug-induced liver injury in patients under treatment with antipsychotic drugs: Data from the AMSP study." World Journal of Biological Psychiatry (2020).

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