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HEPATIC FUNCTION ABNORMAL and Prozac

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HEPATIC FUNCTION ABNORMAL Symptoms and Causes

What is fatty liver disease?

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Fatty liver disease is a condition in which fat builds up in your liver. There are two main types:

  • Nonalcoholic fatty liver disease (NAFLD)
  • Alcoholic fatty liver disease, also called alcoholic steatohepatitis
What is nonalcoholic fatty liver disease (NAFLD)?

NAFLD is a type of fatty liver disease that is not related to heavy alcohol use. There are two kinds:

  • Simple fatty liver, in which you have fat in your liver but little or no inflammation or liver cell damage. Simple fatty liver typically does not get bad enough to cause liver damage or complications.
  • Nonalcoholic steatohepatitis (NASH), in which you have inflammation and liver cell damage, as well as fat in your liver. Inflammation and liver cell damage can cause fibrosis, or scarring, of the liver. NASH may lead to cirrhosis or liver cancer.
What is alcoholic fatty liver disease?

Alcoholic fatty liver disease is due to heavy alcohol use. Your liver breaks down most of the alcohol you drink, so it can be removed from your body. But the process of breaking it down can generate harmful substances. These substances can damage liver cells, promote inflammation, and weaken your body's natural defenses. The more alcohol that you drink, the more you damage your liver. Alcoholic fatty liver disease is the earliest stage of alcohol-related liver disease. The next stages are alcoholic hepatitis and cirrhosis.

Who gets fatty liver disease?

Researchers do not know the cause of nonalcoholic fatty liver (NAFLD). They do know that it is more common in people who

  • Have type 2 diabetes and prediabetes
  • Have obesity
  • Are middle aged or older (although children can also get it)
  • Are Hispanic, followed by non-Hispanic whites. It is less common in African Americans.
  • Have high levels of fats in the blood, such as cholesterol and triglycerides
  • Have high blood pressure
  • Take certain drugs, such as corticosteroids and some cancer drugs
  • Have certain metabolic disorders, including metabolic syndrome
  • Have rapid weight loss
  • Have certain infections, such as hepatitis C
  • Have been exposed to some toxins

NAFLD affects about 25 percent of people in the world. As the rates of obesity, type 2 diabetes, and high cholesterol are rising in the United States, so is the rate of NAFLD. NAFLD is the most common chronic liver disorder in the United States.

Alcoholic fatty liver disease only happens in people who are heavy drinkers, especially those who have been drinking for a long period of time. The risk is higher for heavy drinkers who are women, have obesity, or have certain genetic mutations.

What are the symptoms of fatty liver disease?

Both NAFLD and alcoholic fatty liver disease are usually silent diseases with few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your abdomen.

How do I know if I have fatty liver disease?

Because there are often no symptoms, it is not easy to find fatty liver disease. Your doctor may suspect that you have it if you get abnormal results on liver tests that you had for other reasons. To make a diagnosis, your doctor will use

  • Your medical history
  • A physical exam
  • Various tests, including blood and imaging tests, and sometimes a biopsy

As part of the medical history, your doctor will ask about your alcohol use, to find out whether fat in your liver is a sign of alcoholic fatty liver disease or nonalcoholic fatty liver (NAFLD). He or she will also ask which medicines you take, to try to determine whether a medicine is causing your NAFLD.

During the physical exam, your doctor will examine your body and check your weight and height. Your doctor will look for signs of fatty liver disease, such as

  • An enlarged liver
  • Signs of cirrhosis, such as jaundice, a condition that causes your skin and whites of your eyes to turn yellow

You will likely have blood tests, including liver function tests and blood count tests. In some cases you may also have imaging tests, like those that check for fat in the liver and the stiffness of your liver. Liver stiffness can mean fibrosis, which is scarring of the liver. In some cases you may also need a liver biopsy to confirm the diagnosis, and to check how bad the liver damage is.

What are the treatments for fatty liver disease?

Doctors recommend weight loss for nonalcoholic fatty liver. Weight loss can reduce fat in the liver, inflammation, and fibrosis. If your doctor thinks that a certain medicine is the cause of your NAFLD, you should stop taking that medicine. But check with your doctor before stopping the medicine. You may need to get off the medicine gradually, and you might need to switch to another medicine instead.

There are no medicines that have been approved to treat NAFLD. Studies are investigating whether a certain diabetes medicine or Vitamin E can help, but more studies are needed.

The most important part of treating alcohol-related fatty liver disease is to stop drinking alcohol. If you need help doing that, you may want to see a therapist or participate in an alcohol recovery program. There are also medicines that can help, either by reducing your cravings or making you feel sick if you drink alcohol.

Both alcoholic fatty liver disease and one type of nonalcoholic fatty liver disease (nonalcoholic steatohepatitis) can lead to cirrhosis. Doctors can treat the health problems caused by cirrhosis with medicines, operations, and other medical procedures. If the cirrhosis leads to liver failure, you may need a liver transplant.

What are some lifestyle changes that can help with fatty liver disease?

If you have any of the types of fatty liver disease, there are some lifestyle changes that can help:

  • Eat a healthy diet, limiting salt and sugar, plus eating lots of fruits, vegetables, and whole grains
  • Get vaccinations for hepatitis A and B, the flu and pneumococcal disease. If you get hepatitis A or B along with fatty liver, it is more likely to lead to liver failure. People with chronic liver disease are more likely to get infections, so the other two vaccinations are also important.
  • Get regular exercise, which can help you lose weight and reduce fat in the liver
  • Talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices. Some herbal remedies can damage your liver.

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HEPATIC FUNCTION ABNORMAL Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Not yet recruiting Fluoxetine Prevention Trial
Condition: Cognitive Dysfunction
Interventions: Drug: Fluoxetine;   Drug: Placebo
Outcome Measures: Change from baseline in regional cerebral metabolism;   Durability of the protective effect of fluoxetine;   Change from baseline in neuropsychological (cognitive, functional) test results;   Correlation between cognitive functioning and cerebral metabolism by correlating neuropsychological testing results with PET imaging;   Correlation between inflammatory cytokines and cerebral metabolism by correlating blood cytokine marker levels with PET imaging
2 Not yet recruiting "Evaluation by Transcranial Magnetic Stimulation of the Benefit of Fluoxetine on Motor Recovery After Stroke"
Condition: Cerebral Infarction
Interventions: Drug: Fluoxetine;   Drug: Placebo of fluoxetine
Outcome Measures: Slope of the curve of recruitment of the PEMs;   Slope of recruitment of the PEMs;   Index finger force control in paretic hand under time-course of treatment of Fluoxetine;   in index finger force control in non-paretic hand under time-course of treatment of Fluoxetine
3 Unknown  Predictors of Treatment Response to Fluoxetine in PTSD Following a Recent History of War Zone Stress Exposure
Condition: Posttraumatic Stress Disorder, Combat-related
Interventions: Drug: Fluoxetine;   Drug: Placebo
Outcome Measures: Clinician Administered PTSD Scale;   PTSD Symptom Checklist
4 Recruiting A Study of Olanzapine and Fluoxetine for Treatment-resistant Depression
Condition: Treatment Resistant Depression
Interventions: Drug: Olanzapine;   Drug: Fluoxetine;   Drug: Placebo
Outcome Measures: Mean Change from Baseline to 8 Week Endpoint in Montgomery-Äsberg Depression Rating Scale (MADRS);   Mean Change from Baseline to 8 Week Endpoint in Clinical Global Impressions-Severity of Depression (CGI-S) Scale;   Mean Change from Baseline to 8 Week Endpoint in the Simpson-Angus Scale (SAS);   Mean Change from Baseline to 8 Week Endpoint in the Short-Form 36 Health Survey (SF-36);   Mean Change from Baseline to 8 Week Endpoint in the Sheehan Disability Scale (SDS);   Percentage of Participants who Achieve a Response Based on a ≥50% Reduction from Baseline in MADRS Total Score;   Percentage of Participants who Achieve Remission Based on MADRS Total Score ≤10 at 8 Weeks;   Mean Change from Baseline to 8 Week Endpoint in the Barnes Akathisia Scale (BAS);   Mean Change from Baseline to 8 Week Endpoint in the Abnormal Involuntary Movement Scale (AIMS)
5 Recruiting Role of Inflammation Factors and Insulin Resistance in Major Depressive Disorder
Condition: Major Depressive Disorder
Interventions: Drug: Fluoxetine + Valsartan;   Drug: Fluoxetine + Placebo
Outcome Measures: Hamilton Depression Rating Scale (HDRS);   fasting plasma glucose;   fasting serum insulin;   C-reactive Protein, and IL-6
6 Recruiting Effectiveness Study to Compare Venlafaxine With Fluoxetine in the Treatment of Postmenopausal Women With Major Depression
Condition: Major Depression
Intervention: Drug: venlafaxine,fluoxetine
Outcome Measures: change of 24-item Hamilton Rating Scale for Depression total score;   the mean change of HAMD-24 subscale score in items 10, 11, 12, 13 (anxiety and somatizations) at endpoint
7 Recruiting Fluoxetine for Motor, Aphasia, and Neglect Recovery After Ischemic Stroke
Condition: Stroke
Interventions: Drug: fluoxetine;   Drug: placebo
Outcome Measures: Fugl-Meyer Motor Scale (FMMS);   Western Aphasia Battery;   Behavioral Inattention Test (BIT);   Functional Independence Measure
8 Recruiting Fluoxetine for Motor Recovery After Acute Intracerebral Hemorrhage
Conditions: Intracerebral Hemorrhage;   Motor Impairment
Interventions: Drug: Fluoxetine;   Drug: Placebo
Outcome Measures: Fugl Meyer Motor Scale score;   Barthel Index;   modified Rankin Scale;   NIH Stroke Scale
9 Unknown  Safety and Efficacy of Fluoxetine in Pulmonary Arterial Hypertension
Condition: Pulmonary Arterial Hypertension
Intervention: Drug: Fluoxetine
Outcome Measures: The primary endpoint will be change in pulmonary vascular resistance (PVR) measured by right heart catheterization after three months of therapy.;   Efficacy, Safety and tolerability endpoints will include change between baseline and three month QIDS-SR depression scale, systolic and diastolic blood pressure (systemic) and tabulation of adverse events
10 Recruiting Hypoglycemia Associated Autonomic Failure in Type 1 Diabetes Mellitus (DM)
Conditions: Type 1 Diabetes;   Hypoglycemia Associated Autonomic Failure
Interventions: Drug: Fluoxetine;   Drug: Placebo control
Outcome Measure: Change in Catecholamines
11 Unknown  Pharmacogenomics Studies of Antidepressants
Conditions: Major Depressive Disorder;   Antidepressive Agents;   Pharmacogenetics;   Venlafaxine;   Fluoxetine
Interventions: Drug: Venlafaxine;   Drug: Fluoxetine
Outcome Measures: Hamilton Depression Rating Scale (HDRS);   C-reactive Protein and IL-6;   fasting blood glucose, lipid profiles
12 Recruiting Developing Adaptive Treatment Strategies for Children and Adolescents With Obsessive-compulsive Disorder.
Condition: Obsessive-Compulsive Disorder
Interventions: Drug: fluoxetine;   Behavioral: Group cognitive-behavioral therapy
Outcome Measures: Treatment response status at week 28;   Treatment response status at week 14;   Predictors of treatment response at week 28
13 Not yet recruiting RCT of a Neuroplasticity Agent and CI Therapy for Severe Arm Paresis After Stroke
Condition: Severe Stroke With Affected Arm Motor Function
Interventions: Drug: Fluoxetine;   Drug: Placebo;   Procedure: eCMIT;   Procedure: Usual Care
Outcome Measures: Grade 4/5 Motor Activity Log (MAL) Arm Use Scale;   Grade 4/5 MAL Arm Use scale;   Grade 4/5 Wolf Motor Function Test Performance Rate score
14 Recruiting A Positron Emission Topographic (PET) Study on Depression Patient With Electroacupuncture
Conditions: Major Depressive Disorder;   Depression
Interventions: Drug: Fluoxetine;   Procedure: DCEAS (Hwato®/ Dongbang®);   Procedure: n-CEA (Strietberger®)
Outcome Measures: HAMD-17;   SDS;   PET scanning;   Clinical response;   Remission;   Latency;   Adverse events
15 Recruiting Characterization and Sequential Pharmacotherapy of Severe Mood Dysregulation
Condition: Severe Mood Dysregulation
Interventions: Drug: lisdexamfetamine;   Drug: Placebo;   Drug: fluoxetine
Outcome Measures: Clinical Global Impression-Improvement-Severe Mood Dysregulation;   Pediatric Anxiety Rating Scale (PARS);   Children's Depression Rating Scale;   ADHD-IV Rating Scale;   ADHD IV Rating Scale;   Columbia Suicide Severity Scales;   Barnes Akathisia Scale;   Children's Affective Lability Scale;   Physical Symptom Checklist;   Revised Modified Overt Aggression Scale;   Screen for Children's Affective Reactivity;   Affective Reactivity Index
16 Recruiting Efficacy of Exposure and Response Prevention(ERP) and SSRIs in Chinese OCD Patients
Conditions: Obsessive-Compulsive Disorder;   Anxiety Disorders;   Mental Disorders
Interventions: Drug: Fluoxetine;   Drug: Sertraline;   Drug: Paroxetine;   Drug: Citalopram;   Drug: Fluvoxamine;   Behavioral: Exposure and Response Prevention
Outcome Measures: The change of Yale-Brown Obsessive-Compulsive Scale score;   The change of Beck Depression Inventory(BDI-II) score;   The change of Beck Anxiety Inventory(BAI) score;   The change of Stress Perceived Questionnaire (PSS-10) score;   The change of Behavioral Inhibition/Behavioral Activation System Scales score;   The change of Barratt Impulsiveness Scale 11 (BIS-11) score;   The change of Obsessive Beliefs Questionnaire-44(OBQ-44) score;   The NEO-Five Factor Inventory-Revised (NEO-FFI-R);   The Early Trauma Inventory Self Report-Short Form(ETISR-SF)
17 Recruiting Clinical Trial of Fluoxetine in Anxiety and Depression in Children, and Associated Brain Changes
Conditions: Depression;   Mood Disorder;   Anxiety Disorder;   Healthy
Intervention:
Outcome Measure:
18 Recruiting Comparing Treatments for Self-Injury and Suicidal Behavior in People With Borderline Personality Disorder
Conditions: Borderline Personality Disorder;   Suicide
Interventions: Drug: Fluoxetine;   Behavioral: DBT;   Drug: Citalopram
Outcome Measure: Suicidal and self-injurious behavior
19 Recruiting An Adaptive Treatment Strategy for Adolescent Depression-Continuation
Condition: Adolescent Depression
Interventions: Drug: Fluoxetine;   Behavioral: Interpersonal Psychotherapy
Outcome Measures: K-SADS-PL - baseline; change from baseline in KSADS at week 16 and 32;   BDI-II-baseline; change from baseline in BDI at weeks 4/8/12/16/24/32;   HRSD-baseline; change from baseline in HRSD at weeks 4/8/12/16/24/32;   CSSR-S-baseline; change from baseline in CSSR-S at weeks 4/8/12/16/24/32
20 Recruiting An Adaptive Treatment Strategy for Adolescent Depression
Condition: Adolescent Depression
Interventions: Drug: Fluoxetine;   Behavioral: Interpersonal Psychotherapy
Outcome Measures: K-SADS-PL - baseline; change from baseline in KSADS at week 16 and 32;   BDI-II-baseline; change from baseline in BDI at weeks 4/8/12/16/32;   HRSD-baseline; change from baseline in HRSD at weeks 4/8/12/16/32;   CSSR-S-baseline; change from baseline in CSSR-S at weeks 4/8/12/16/32