Acute Drug-Induced Hepatitis during Aripiprazole Monotherapy: A Case Report

Abstract

Only a few case studies have been reported about antipsychotic-induced hepatitis for second generation antipsychotics. A 52-year old patient with recurrent schizoaffective psychosis was switched over from clozapine to aripiprazole monotherapy. Six weeks afterwards the otherwise asymptomatic patient presented herself with skin and scleral jaundice. Hepatic laboratory parameters and liver histological evaluation were initiated. Blood tests performed in outpatient clinic revealed significantly pathological hepatic laboratory parameters (total bilirubin 17.9 mg/dl, direct bilirubin 9.0 mg/dl, GOT 1613 U/l, GPT 2585 U/l). The liver histological evaluation shows a portal inflammatory cellular reaction with eosinophilia. After immediate discontinuation of aripiprazole medication, the elevated laboratory parameters normalised. We assume that the patient had suffered drug-induced hepatitis with predominant cytolysis. This is the first case of aripiprazole-induced hepatitis described in the literature.