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Chronic Active Hepatitis Associated with Trazodone Therapy

Paul L. Beck, MD; Ronald J. Bridges, MD; Douglas J. Demetrick, MD; James K. Kelly, MB; and Samuel S. Lee, MD
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From the University of Calgary, Calgary, Alberta. Requests for Reprints: S. S. Lee, MD, 3330 University Drive Northwest, Calgary, Alberta T2N 4N1, Canada.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;118(10):791-792. doi:10.7326/0003-4819-118-10-199305150-00006
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Trazodone is a widely used nontricyclic antidepressant agent that has been commercially available in North America for more than 10 years. There have been three previously reported cases of trazodone-induced hepatic injury, all of which resolved within 4 to 24 weeks after cessation of the drug. We report the first documented case of trazodone-induced chronic active hepatitis. The patient developed jaundice 8 months after beginning therapy with the drug. Her liver enzymes were markedly elevated, and mild portal hypertension was present at transjugular liver biopsy. The biopsy specimen showed a pattern consistent with chronic active hepatitis. Investigations of other possible causes of chronic active hepatitis were negative, and serum transaminase enzyme levels rapidly returned to normal after withdrawal of trazodone. We suggest that physicians be alert to the possibility of hepatic injury in patients receiving trazodone.


Grahic Jump Location
Figure 1.
Liver specimen showing the pattern of chronic active hepatitis.

Two parenchymal nodules are separated by an expanded portal tract. Piecemeal necrosis and thickening of liver cell plates are evident.

Grahic Jump Location




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