From the Research
Vortioxetine generally does not significantly increase liver enzymes for most patients. While rare cases of liver enzyme elevations have been reported with vortioxetine use, these occurrences are uncommon and typically mild. The medication is not considered to have a high risk of hepatotoxicity compared to some other antidepressants. However, patients with pre-existing liver disease should use vortioxetine with caution, and routine monitoring of liver function may be appropriate in these individuals.
Key Points to Consider
- During clinical trials, the incidence of clinically significant liver enzyme elevations with vortioxetine was similar to placebo 1.
- The medication is primarily metabolized by the liver through multiple cytochrome P450 enzymes, particularly CYP2D6, but this normal metabolism process doesn't typically lead to liver damage.
- If a patient experiences symptoms like jaundice, dark urine, right upper quadrant pain, or unexplained fatigue while taking vortioxetine, they should contact their healthcare provider promptly as these could indicate liver problems requiring medical evaluation.
Comparison with Other Antidepressants
- Other antidepressants, such as sertraline, have been associated with a higher risk of liver injury 2, 3.
- The risk of hepatotoxicity with vortioxetine is considered lower compared to some other antidepressants, such as iproniazid, nefazodone, phenelzine, imipramine, amitriptyline, duloxetine, bupropion, trazodone, tianeptine, and agomelatine 4.
- Monitoring of liver function tests and immediate discontinuation upon abnormal lab findings or signs and symptoms of liver dysfunction are crucial since most cases of hepatic damage are reversible when detected early 5.