Clinical Psychopharmacology and Neuroscience 2019; 17(4): 551-555  
Aripiprazole-induced Hepatitis: A Case Report
Lígia Castanheira1,*, Elsa Fernandes1,*, Pedro Levy1, Ricardo Coentre1,2
1Department of Psychiatry, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, EPE, 2Clínica Universitária de Psiquiatria, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Correspondence to: Ricardo Coentre
Department of Psychiatry, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal
E-mail: Ricardo.Coentre@netc.pt
ORCID: https://orcid.org/0000-0002-2939-9436
*These authors contributed equally to this study.
Received: April 11, 2018; Revised: May 27, 2018; Accepted: June 26, 2018; Published online: November 30, 2019.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Aripiprazole is an atypical antipsychotic that acts as a partial agonist of dopamine type 2 receptors as well as 5-HT1A receptors. It is used in the treatment of schizophrenia and in type 1 bipolar disorder for mania. Because aripiprazole is well tolerated with few side effects it is used off-label in other psychotic disorders. The prevalence of abnormal liver function tests with antipsychotic use is 32%, with clinically significant effects in 4% of cases. No cases of aripiprazole-induced liver injury have been published. We report a 28-year-old female who presented with non-affective first-episode psychosis and who was treated with aripiprazole. Initially she was medicated with 10 mg per day, with an increase to 20 mg per day on the 12th day of hospitalization. Nine days after she became icteric, with nausea and had a vomiting episode. Laboratory analysis revealed a very high level of alanine aminotransferase, and minor to moderately high levels of aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, and bilirubin. Aripiprazole was tapered and paliperidone was started with the improvement of clinical and laboratory findings.
Keywords: First-episode psychosis; Psychosis; Aripiprazole; Transaminases; Hepatitis.


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