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Psychopharmacology and Psychiatry Updates

Balancing Benefits and Risks: Antipsychotics in Hepatic Dysfunction

Jun 25, 2024
In this engaging discussion, Dr. Sydney LeFay, a medical professional specializing in psychiatric care, shares her expertise on prescribing antipsychotics to patients with liver disease. She highlights the critical need for a risk-benefit analysis in complex cases and outlines strategies for safe medication selection. The conversation dives into the types of liver injuries associated with these medications and emphasizes the importance of monitoring liver function. Overall, Dr. LeFay advocates for a collaborative treatment approach to ensure patient safety.
11:10

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Quick takeaways

  • The careful selection and monitoring of lower-risk antipsychotics in patients with liver disease is essential to ensure safety and effectiveness.
  • Psychiatrists must balance the risks of liver injury with the benefits of antipsychotic treatment through tailored monitoring and collaborative care.

Deep dives

Understanding Drug-Induced Liver Injury

The pathophysiology of drug-induced liver injury is crucial for psychiatrists, especially when prescribing antipsychotics to patients with liver disease. There are two subtypes: intrinsic injury, which is dose-dependent and manifests quickly, and idiosyncratic injury, which occurs independently of the dose and can develop over extended periods. Antipsychotics generally fall under the idiosyncratic category, making it challenging to predict which patients will experience liver injury. Factors such as advanced age, non-alcoholic fatty liver disease, and polypharmacy increase the risk, emphasizing the need for careful monitoring.

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