Cross hepatotoxicity between tricyclic antidepressants and phenothiazines

Eur J Gastroenterol Hepatol. 1995 Apr;7(4):373-6.


Objective: To describe a case of cross hepatotoxicity between tricyclic antidepressants and phenothiazines.

Patient: A woman who developed three episodes of drug-induced hepatitis within 3 years as a result of successive treatment with two tricyclic antidepressants, trimipramine and desipramine, and one neuroleptic derivative, cyamemazine.

Interventions: The drugs were withdrawn after the patient experienced liver dysfunction, although bromazepam was later administered with no side effects.

Results: After three episodes of drug-induced hepatitis the patient's serum aspartate aminotransferase and alanine aminotransferase levels returned to normal when the tricyclic antidepressants and cyamemazine were withdrawn.

Conclusions: Trimipramine, desipramine and cyamemazine are related by their chemical structures which include a tricyclic ring. This suggests that this chemical moiety might be involved in the hepatotoxicity of tricyclic antidepressants and phenothiazine derivatives.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antidepressive Agents, Tricyclic / toxicity*
  • Chemical and Drug Induced Liver Injury / etiology
  • Desipramine / toxicity
  • Female
  • Humans
  • Liver / drug effects*
  • Phenothiazines / toxicity*
  • Structure-Activity Relationship
  • Trimipramine / toxicity


  • Antidepressive Agents, Tricyclic
  • Phenothiazines
  • Trimipramine
  • cyamemazine
  • Desipramine