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Dr. Owen
Dr. Owen, Doctor
Category: Health
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Experience:  Board Certified Physician and US Medical School Graduate
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What antidepressants that inhibit norepinephrine reuptake are

Customer Question

What antidepressants that inhibit norepinephrine reuptake are ok for someone with mild pre-existing liver damage?
Submitted: 4 years ago.
Category: Health
Expert:  Dr. Owen replied 4 years ago.

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Hello, and I am pleased to help, use of my answers are for educational purposes only.
What medications have you tried yet?
Customer: replied 4 years ago.
None.
Expert:  Dr. Owen replied 4 years ago.
You can try some of the newer medications such as Pristiq (desvenlafexine), Effexor (venlafaxine), Cymbalta (duloxetine).
These will help, but I would still watch your liver enzymes to make sure they are not getting elevated while taking any one of these medications.
Customer: replied 4 years ago.
Relist: Inaccurate answer.
Did not answer my question, instead just listed common antidepressants in this category. In fact, Cymbalta just received a strengthened warning from the FDA for people with liver damage.
Expert:  Dr. Owen replied 4 years ago.
Yes, I understand that - but the only way to really know if these medications will effect you is to understand the risks, and then keep evaluating your liver enzymes such as AST and ALT. There are no safe antidepressants that are entirely safe as they are ALL metabolized by the liver.

Edited by Dr. Wilson on 10/1/2010 at 4:06 PM EST
Customer: replied 4 years ago.
Relist: Answer quality.
Expert:  Dr. Owen replied 4 years ago.
I understand your frustrations, but every medication for antidepressant is metabolized by the liver, so hence with liver problems you need to be watching your liver enzymes. I'm sorry, but there is no way around this. There are only a few ways that medications are metabolized in the body - by the liver and by the kidney, so for the medications for depressant and anxiety, these would be metabolized by the liver.

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