Acute transaminitis after initial days of starting haloperidol

Haloperidol is a first-generation antipsychotic butyrophenone that is lipophilic, readily absorbed, and extensively metabolized in the liver. The occurrence of elevated liver enzymes with haloperidol is reported to be 2.4% with cases generally occurring in the setting of chronic use. In this case, w...

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Main Authors: Rami Gabriel, Todd Wojtanowicz, Reza Farokhpay, Robert Bota
Format: Article
Language:English
Published: Wiley 2019-06-01
Series:Mental Illness
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Online Access:https://www.pagepress.org/journals/index.php/mi/article/view/8113
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author Rami Gabriel
Todd Wojtanowicz
Reza Farokhpay
Robert Bota
author_facet Rami Gabriel
Todd Wojtanowicz
Reza Farokhpay
Robert Bota
author_sort Rami Gabriel
collection DOAJ
description Haloperidol is a first-generation antipsychotic butyrophenone that is lipophilic, readily absorbed, and extensively metabolized in the liver. The occurrence of elevated liver enzymes with haloperidol is reported to be 2.4% with cases generally occurring in the setting of chronic use. In this case, we present a patient who developed elevated liver enzymes 1-2 days after starting haloperidol treatment on two separate occasions and in the context of negative hepatic viral and autoimmune serology. Liver enzymes consistently had alanine transaminase > aspartate transaminase and peaked at 288 U/L prior to discontinuation of the medication. The patient was taken off haloperidol after serology resulted and clozapine regimen started. He was able to tolerate clozapine well with recovery of his transaminitis and psychiatric stabilization.
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publishDate 2019-06-01
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series Mental Illness
spelling doaj-art-b6579c851c1a4dc0acf76fb4edb88e812025-08-20T03:20:54ZengWileyMental Illness2036-74572036-74652019-06-0111110.4081/mi.2019.8113Acute transaminitis after initial days of starting haloperidolRami Gabriel0Todd Wojtanowicz1Reza Farokhpay2Robert Bota3School of Medicine, University of California, Irvine, CADepartment of Psychiatry, University of California, Irvine, CASchool of Medicine, and Department of Psychiatry, University of California, Irvine, CASchool of Medicine, and Department of Psychiatry, University of California, Irvine, CAHaloperidol is a first-generation antipsychotic butyrophenone that is lipophilic, readily absorbed, and extensively metabolized in the liver. The occurrence of elevated liver enzymes with haloperidol is reported to be 2.4% with cases generally occurring in the setting of chronic use. In this case, we present a patient who developed elevated liver enzymes 1-2 days after starting haloperidol treatment on two separate occasions and in the context of negative hepatic viral and autoimmune serology. Liver enzymes consistently had alanine transaminase > aspartate transaminase and peaked at 288 U/L prior to discontinuation of the medication. The patient was taken off haloperidol after serology resulted and clozapine regimen started. He was able to tolerate clozapine well with recovery of his transaminitis and psychiatric stabilization.https://www.pagepress.org/journals/index.php/mi/article/view/8113HaldolTransaminitisSchizophreniaLiver toxicity
spellingShingle Rami Gabriel
Todd Wojtanowicz
Reza Farokhpay
Robert Bota
Acute transaminitis after initial days of starting haloperidol
Mental Illness
Haldol
Transaminitis
Schizophrenia
Liver toxicity
title Acute transaminitis after initial days of starting haloperidol
title_full Acute transaminitis after initial days of starting haloperidol
title_fullStr Acute transaminitis after initial days of starting haloperidol
title_full_unstemmed Acute transaminitis after initial days of starting haloperidol
title_short Acute transaminitis after initial days of starting haloperidol
title_sort acute transaminitis after initial days of starting haloperidol
topic Haldol
Transaminitis
Schizophrenia
Liver toxicity
url https://www.pagepress.org/journals/index.php/mi/article/view/8113
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AT toddwojtanowicz acutetransaminitisafterinitialdaysofstartinghaloperidol
AT rezafarokhpay acutetransaminitisafterinitialdaysofstartinghaloperidol
AT robertbota acutetransaminitisafterinitialdaysofstartinghaloperidol