Medical-News-Researchers-Warn-That-SSRIs-Such-as-Sertraline-Fluoxetine-and-Fluvoxamine-Can-Cause-Liver-Injuries
Nikhil Prasad Fact checked by:Thailand Medical News Team Jun 13, 2026 6 days, 3 hours, 51 minutes ago
Medical News: A new study has raised concerns about the potential risk of liver injury linked to commonly prescribed antidepressants known as selective serotonin reuptake inhibitors (SSRIs), including sertraline, fluoxetine, fluvoxamine, paroxetine, citalopram, and escitalopram. While these medications are widely used to treat depression, anxiety disorders, and other mental health conditions, researchers have found evidence suggesting that some patients may develop serious liver-related complications shortly after starting treatment.
New research suggests commonly prescribed SSRIs may trigger liver damage in some patients, especially during the
first month of treatment.
The research was conducted by scientists from the Shenzhen Institute of Pharmacovigilance and Risk Management in Shenzhen, China, and Jinan University in Guangzhou, China. The team analyzed reports from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database spanning a decade from 2013 to 2023.
Liver Injury Signals Found Across Multiple SSRIs
The researchers examined reports of drug-induced liver injury (DILI) associated with six commonly prescribed SSRIs. They found that liver injury reports were most frequently recorded among women and individuals aged between 18 and 64 years.
Among the drugs studied, sertraline generated the highest number of liver injury reports, while fluvoxamine generated the fewest. However, all SSRIs examined showed signals indicating potential liver toxicity. Commonly reported liver problems included hepatocellular injury, which involves damage to liver cells, and liver tissue necrosis, where liver cells die due to severe injury.
The study also identified distinct liver-related risks associated with specific medications. Fluoxetine was linked to hepatic steatosis, commonly known as fatty liver disease. Paroxetine showed a unique association with chronic active hepatitis, a long-term inflammatory liver condition. Sertraline was associated with some of the most severe liver complications, including liver failure, primary biliary cholangitis, and hemorrhagic hepatic cysts.
Most Cases Occurred Within the First Month
One of the most important findings was that the median time to the onset of liver injury occurred within the first month after beginning SSRI treatment. This suggests that patients and healthcare providers should be especially vigilant during the early stages of therapy.
The analysis also identified factors linked to a higher risk of death among affected patients. Individuals aged 18 to 44 years were found to have a significantly increased mortality risk. Body weight also appeared to influence outcomes, highlighting the importance of individualized patient monitoring.
This
Medical News report notes that while severe liver injury remains relatively uncommon, the findings suggest that early warning signs such as fatigue, nausea, abdominal pain, dark urine, jaundice, and unexplained itching should never b
e ignored in patients taking SSRIs.
Possible Biological Mechanisms Revealed
To better understand why these drugs may damage the liver, the researchers conducted network pharmacology analyses. Their findings pointed toward disruptions in cytochrome P450 enzyme systems, which play a critical role in drug metabolism. They also identified abnormal regulation of cellular apoptosis, a process involved in programmed cell death.
In addition, drug-specific pathways were identified. Sertraline appeared to be linked to alterations in the PI3K-Akt signaling pathway, while fluoxetine and fluvoxamine were associated with changes in IL-17 signaling, a pathway involved in inflammation and immune responses.
Conclusions
The study highlights that liver injury linked to SSRIs may occur more often than previously appreciated, particularly during the first month of treatment and among female patients. The findings also demonstrate that individual SSRIs may carry distinct liver toxicity profiles. Although the research does not prove direct causation, it provides important evidence supporting closer monitoring of liver health in patients prescribed these antidepressants and underscores the need for larger prospective studies to confirm the risks and improve personalized treatment strategies.
The study findings were published as an abstract in the peer reviewed journal: Frontiers in Pharmacology. A detailed paper will be followed soon.
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1842778/abstract
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