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Re: Help!-Compromised Liver Needs AD

Posted by Sunnely on February 23, 2002, at 14:52:46

In reply to Help!-Compromised Liver Needs AD, posted by mdertinger on February 23, 2002, at 10:07:19

> Again, any suggestions on meds that might help depression and/or anxiety, but do NOT impact the liver?
> Thanks!

I will definitely avoid nefazodone (Serzone). Although considered rare, there have been case reports of acute liver failure with the use of this drug.

Virtually all antidepressants are metabolized by the liver. So, dosing will be the main issue. For those with kidney or liver damage, 30-50% of the normal adult dose is generally recommended.

If an anti-anxiety is required, choose an anti-anxiety drug that does not undergo active liver metabolism such as lorazepam (Ativan). I will definitely avoid the long-acting benzos such as Valium and Librium. They undergo active liver metabolism, have long half-lives and converted into active metabolites. Gabapentin (Neurontin), an anticonvulsant with numerous other clinical uses including anxiety/insomnia will be a good choice, too. It is not metabolized by the liver.


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