I was seing a 39 years old lady for complaint of mild pain abdomen on her right upper quadrant. On examination there was mild tenderness on right upper quadrant but normal general examination. Her USG whole abdomen revealed normal scan, All blood parameters were within normal limits.I prescribed her PPI and buscopan for pain and she had improved clinically but then after about 3 months she czme back with c/o black stool and fatigue.I admitted her as she had developed jaundice and her stool OBT was positive.Within 2-3 days of conservative management she devloped acute hepatic failure state and was referred to tertiary care unit where she died after 3 days. Later her family gave the information that she used to take antidepressants since 2 years which she didnt disclose for unknown reason. She also used to take alcohol occasionally as told by family later. I was wondering for the possible reasons about her acute hepatic failure. Please put some lights into the case.