Acute Drug-Induced Hepatitis Associated With Vortioxetine: A Case Report

Drug-induced liver injury (DILI) is an uncommon but potentially serious adverse reaction that can arise from the use of various antidepressants. Vortioxetine, widely used for the treatment of major depressive disorder due to its favorable efficacy and tolerability profile, has been infrequently associated with hepatic toxicity. We describe the case of a 59-year-old female who developed acute hepatitis with cholestatic features after long-term vortioxetine therapy. Extensive evaluation ruled out viral, autoimmune, and metabolic causes. Liver function improved after the discontinuation of the drug but worsened upon rechallenge, necessitating permanent withdrawal of the drug. A subsequent episode of hepatic failure after exposure to venlafaxine suggested a class-related susceptibility to selective serotonin reuptake inhibitor (SSRI)-induced hepatotoxicity. The patient recovered following cessation of antidepressants and treatment with N-acetylcysteine. This report underscores the importance of considering DILI in patients treated with vortioxetine or other serotonergic antidepressants.