title: Prospective study of FK506 side effects: anxiety or akathisia?
abstract: FK506 is a macrolide immunosuppressant agent used in solid organ and bone marrow transplantation and for autoimmune disorders. FK506 is reported to have a number of neuropsychiatric side effects, including anxiety and tremor. Because FK506 was implicated in causing akathisia in a case report, we did a prospective, cross-sectional study of 25 renal transplant recipients to determine whether akathisia occurred and/or had a relationship to FK506 plasma levels. The Symptom Checklist-90-R, Hamilton Anxiety (HAM-A), and Akathisia Rating (ARS) scales were administered. Higher FK506 plasma levels correlated with higher HAM-A scores. ARS scores did not correlate with FK506 plasma levels; however, when FK506 plasma levels were divided into "high" (> or = 0.9 ng/mL) and "low" (< 0.9 ng/mL) groups, total ARS and HAM-A scores were significantly higher in the "high" group. We discuss implications of these findings as well as management.
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA 15213, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: DiMartini
authors.forename: P T
authors.initials: PT
authors.lastname: Trzepacz
authors.forename: S R
authors.initials: SR
authors.lastname: Daviss
mesh_terms: D000328:Adult; D000368:Aged; D017109:Akathisia, Drug-Induced / Q000503:physiopathology*; D001007:Anxiety / Q000139:chemically induced* / Q000523:psychology; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000097:blood; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D016559:Tacrolimus / Q000009:adverse effects* / Q000097:blood
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus