Antidepressants - bad for the liver?

I am talking to my doctor about getting back on antidepressants for anxiety and have found conflicting information online if SSRI’s impair hepatic function. There is a case report here > Escitalopram-induced liver injury: A case report and review of literature - PMC where a lady was presented with fever and cholestatic liver injury two weeks after initiation of escitalopram for the treatment of psychotic depression. Upon stopping escitalopram, repeat liver function tests showed downtrending liver enzymes with eventual normalization of serum aspartate aminotransferase and alanine aminotransferase one-week post-discharge.

This is just one case report, but when I read Zoloft’s highlight of prescription medication, it talks about hepatic function and how people with hepatic impairment should receive half of the recommended dose.

Any insight on this matter?

Why do you want to take anti depressants for anxiety? Just asking. It’s almost like taking Tylenol flu for a simple headache.

How Antidepressants Work. SSRIs and SNRIs work by targeting neurotransmitters in your brain such as serotonin, which affect your sleep, anxiety, mood, and general feelings of comfort. Since taking an SSRI or SNRI increases the serotonin in the brain , it could help with anxiety.

I was on antidepressants for 2 years and it helped a ton for anxiety. FDA approves many SSRI’s for generalized anxiety disorder.

So it’s definitely not like taking Tylenol flu for a headache.

I’m assuming you’re not familiar with antidepressants so I’m going to leave this helpful article here.

Antidepressant Medications | CAMH.


I sometimes take anxiety meds but generic Xanax. I was prescribed.5mg but sometimes split the pill in half. I tend to just pass out at night after taking it. I sometimes have anxiety and mind just wonders off. Not in a depressed/sad way, but more like what am I going to do deal. It just mellow me out. But I don’t have depression, so I don’t take antidepressants for my anxiety.

Not saying you don’t have depression. I was just wondering, bc I have been taking it for years. Sometimes I go months not taking it, other times I take it daily for a week and then I m off. Were you diagnosed with depression or was it something (medication) you ask your doctor for.

I referenced the Tylenol flu to regular Tylenol bc it’s the same thing but just with chest/cough suppressants. regular Tylenol works well for colds as well. Again just wondering because I have anxiety.

Article on medication

Thanks for your insight. I understand. I chose not to go on anti anxiety from the recommendation of my doctor. From what I’ve learned it sounds like anti anxiety medications can be addictive and they aren’t meant to be taken long term. With antidepressants, they’re recommended for long term use for depression and anxiety.

Hi @Carol1420,

We do have some pharmacists on this forum that might be able to provide more detail @hope4us, @Patricia, @Prince_Okinedo, @Cornelius.

However, I do note that this appears to be a very rare event: in this large study (Drug-Induced Liver Injury during Antidepressant Treatment: Results of AMSP, a Drug Surveillance Program | International Journal of Neuropsychopharmacology | Oxford Academic) SSRIs seem to be the safest antidepressants with respect to hepatotoxicity (0.03%).



I have been on the SSRI for 14 years, escitalopram is safe mostly, but you must check with your liver specialist first before start taking it


The Paracelsus’ philosophy that all drugs are poisons:the dose is what differentiates still holds. However, a broader way we look at this is a drug’s pharmacokinetic profile, which include absorption, distribution, metabolism and excretion. Very importantly, it’s excretion (clearance after administration).
The inference we can draw from several studies of the impact of antidepressants on the liver cells is that NONE is absolutely safe. However, the extent of assault on the liver cells vary.
Antidepressants in the Selective serotonin reuptake inhibitors (SSRIs) and Serotonin-norepinephrine reuptake inhibitors (SNRIs) class have been reported to have better safety profile. But this also depends on a number of factors for individual drug in these classes.
For those cleared observed with a high percentage of unchanged form in the urine are considered much more safer and drug of choice, like the desvelafaxine, a synthetic metabolite of venlafaxine.
The key point here irrespective of whatever class one is taking is monitoring, monitoring and monitoring of the liver enzymes and other biomarkers to ensure that all is well. I hope this helps @Carol1420.


I’ve been taking the antidepressant escitalopram (Lexapro) for nearly two decades and my liver values have always been fine.

Prior to this I was taking the antidepressant nefazodone (Serzone) for about five years without any liver issues to it but I was taken of of that due to reports coming out that it caused liver damage where it was then finally taken off the market in the US. Unfortunately, you can still get generic nefazodone but the manufactures have added a “Black Box Warning” to it to inform patents that it can cause liver harm.