Drug-induced liver injury or DILI, in short, is a common condition observed with many medicinal products and health supplements. The agents range from antibiotics, cholesterol-lowering drugs, pain killers to herbal supplements and fish oil found over the counter.
Similar to the above examples, anti-depressants such as agomelatine may also induce liver injury to various extents. The injury mostly manifests as elevated liver enzymes without obvious symptoms. In very rare cases, one may present with yellow discolouration of the eyes and nausea or vomiting. This usually signifies severe liver injury or impending liver failure.
As liver injury happens silently at the beginning, it is prudent to have your liver function monitored regularly while you are on anti-depressants such as agomelatine. Any liver enzyme elevation above 3 to 5 times the upper limit should call for a dose reduction or cessation of treatment. If detected early, the majority of there injuries recover without any long term consequences. You will likely need the help of a liver specialist should the abnormality persist despite stopping the anti-depressant.
