Can paroxetine cause abnormal liver function values?/nThe question concerns a 30-year-old anorexic

Fråga: Can paroxetine cause abnormal liver function values?

The question concerns a 30-year-old anorexic patient, who has been treated for the last month with Seroxat (paroxetine) 20 mg daily. One week ago high liver function values were observed in connection with a routine control: ASAT 2.81, GT 4.16, ALP 7.2. The patient has diabetes, treated with insulin, and is also taking Prepulsid (cisaprid). However, the patient has had a history of elevated liver function values even earlier and it is unclear whether the values have increased after paroxetine was started.

Sammanfattning: The documentation concerning paroxetine and possible liver damage is scarce. In one study two of 20 treated patients were reported to have a rise in liver enzymes. A total of seven cases has been reported to SADRAC. A connection between paroxetine or cisaprid treatment and the pathological liver function values in this patient cannot be excluded.

Svar: A question concerning possible liver damage in connection with paroxetine treatment was handled one year ago (1). One study is referred to, according to which a rise in liver enzymes was found in two patients after treatment with paroxetine in a group of 20 patients. A follow-up literature search, including communication with the manufacturer, has revealed no additional documentation. A total of seven cases of reversible liver damage caused by paroxetine have been reported to SADRAC since 1991 (2): increased transaminases (3 cases), mixed liver reaction (1 case), increased transaminases ALP/GT (3 cases). We recommend that this case be reported to SADRAC.

According to FASS, cisaprid (Prepulsid) can cause disturbances of liver function in rare cases (less than 1/1000). However, no cases have been reported to SADRAC.