Acute Hepatic Necrosis Following Treatment with Amitriptyline and Diazepam

¹ Registrar, Springfield Hospital, Beechcroft Road, Upper Tooting, S.W.17

A case is described of death due to acute hepatic necrosis, in which the patient had been taking regular antidepressant therapy (amitriptyline and diazepam) in therapeutic dosage for six months. No ill effects were noted until the onset of deterioration which necessitated her admission to hospital, where she died after a short illness. There was no history of previous liver disease or ingestion of any other known hepatotoxic substance, and the patient had been considered in good physical health by her family.

Attention is drawn to the association of liver necrosis and the ingestion of amitriptyline and diazepam, although a direct cause and effect relationship cannot be concluded from the available evidence. The use of both these drugs is widespread, singly and in combination, in this hospital, and to date there has been no more serious complications reported here than blurred vision, dryness of the mouth, or mild hypotensive symptoms.