The American Journal of Psychiatry reports

In December 2013, researchers reported in The American Journal of Psychiatry that. Drug-induced liver injury (DILI) was found in 0.05-3.0% of those taking antidepressants.

The researchers did a PubMed review from 1965 to the present, and reported that all antidepressants can induce hepatotoxicity (liver cell damage or destruction), especially in elderly patients or patients taking multiple prescription medications. This chemically driven cell damage was found to be unrelated to drug dosage and generally occurred between several days and 6 months of starting the medication.


The antidepressants associated with greater risks of damaging the liver are:

  • iproniazid
  • nefazodone
  • phenelzine
  • imipramine
  • amitriptyline
  • duloxetine
  • bupropion
  • trazodone
  • tianeptine
  • agomelatine

The antidepressants that seem to have the least potential to damage the liver are:

  • citalopram
  • escitalopram
  • paroxetine
  • fluvoxamine

The researchers conclude

Although an infrequent event, DILI from antidepressant drugs may be irreversible, and clinicians should be aware of it.


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