Abstract
Four patients developed acute hepatitis after receiving Atrium, an association of phenobarbital, febarbamate and difebarbomate, for the treatment of tremor or for the prevention of alcohol withdrawal symptoms. Hepatitis occurred 1 to 3 months after treatment. Asthenia was the unique clinical manifestation. Marked increase in serum aminotransferases and gamma-glutamyltranspeptidase levels were the main biological features. Histological examination showed liver cell necrosis in two cases, prominent in the centrolobular area in one case. There was no case of hepatic failure. Atrium withdrawal was followed by complete recovery within 6 to 12 weeks. The mechanism of Atrium hepatotoxicity remains unknown.
MeSH terms
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Aged
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Aged, 80 and over
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Alanine Transaminase / blood
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Alcohol Withdrawal Delirium / drug therapy
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Alcohol Withdrawal Delirium / prevention & control
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Aspartate Aminotransferases / blood
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Barbiturates / adverse effects*
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Barbiturates / therapeutic use
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Chemical and Drug Induced Liver Injury / etiology*
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Drug Combinations
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Female
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Humans
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Male
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Middle Aged
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Phenobarbital / adverse effects*
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Phenobarbital / therapeutic use
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Psychotropic Drugs / adverse effects
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Psychotropic Drugs / therapeutic use
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gamma-Glutamyltransferase / blood
Substances
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Barbiturates
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Drug Combinations
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Psychotropic Drugs
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difebarbamate, febarbamate, phenobarbital drug combination
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gamma-Glutamyltransferase
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Aspartate Aminotransferases
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Alanine Transaminase
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Phenobarbital