Liver toxicity of Naltrexone. a case study and review of literature

Alcohol Use Disorder (AUD) is becoming a growing problem worldwide.1 As a chronic and relapsing disease, it can cause multisystem changes and can lead to important damages specifically in the liver and the brain.2,3 Liver remain the primary target for the detrimental effects of alcohol since ethanol is mainly metabolized by liver cells, through two major alcohol oxidizing enzymes, alcohol dehydrogenase and CYP2E1.4 Elevated liver tests due to toxic effects of ethanol are the most common laboratory findings in alcohol abuse. However, other organs, including brain, gut, pancreas, lungs and the immune system are also affected by alcohol. Vitamin deficiencies leading to serious problems such as Korsakoff syndrome5 memory impairment are frequent among those with alcohol use disorders. Alcohol may also serve to intensify the progression of viral infections, autoimmune diseases and cancer by increasing the oxidative stress, dysregulation in lipid and protein metabolism. Despite psychosocial approach, several efficacious pharmacotherapies as Naltrexone, acomprassate or disulfiram are currently approved for managing AUD. They target specific aspects of biology metabolism and neurobehavioral mechanisms responsible for craving or urge for alcohol.6