Unpredictable Course of an Escitalopram-Induced Liver Injury: A Case Report

Escitalopram is a selective serotonin reuptake inhibitor and one of the most widely prescribed antidepressants in the world. Very few cases of drug induced liver injury (DILI) have been reported in patients on escitalopram. We describe here an unusual case of hepatocellular injury in a 32-year-old Moroccan woman on birth control by second-generation combined oral contraceptives (COCs) treated for depression by escitalopram. Despite initial improvement upon escitalopram discontinuation, liver enzyme levels fluctuated, necessitating further management adjustments. This case highlights the complexity and unpredictable course of DILI and suggests a possible synergetic drug-interaction as a contributing factor.