title: Tacrolimus-induced paranoid delusions and fugue-like state.
abstract: We report the case of a 43 year old male with no prior psychiatric history with apparent tacrolimus-induced psychosis. Previous reports have identified other neurotoxic adverse effects due to tacrolimus, however, to our knowledge, there are few reports that describe psychosis induced by the immunosuppressant drug. Although psychosis may be a rare adverse effect, it can have significant impact on the long-term prognosis and treatment in transplant recipients. It is imperative to quickly identify patients who develop a mental status change while on tacrolimus and to work with the appropriate transplant team in managing these patients. Treatment usually calls for prompt discontinuation of tacrolimus, substituting with another immunosuppressant, and possible use of antipsychotics.
authors.affiliation: Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA. nkrishna@psych.umaryland.edu
authors.forename: Nithin
authors.initials: N
authors.lastname: Krishna
authors.forename: Joshua
authors.initials: J
authors.lastname: Chiappelli
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Fischer
authors.forename: Stephanie
authors.initials: S
authors.lastname: Knight
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003702:Delusions / Q000139:chemically induced; D004213:Dissociative Disorders / Q000139:chemically induced; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D010259:Paranoid Disorders / Q000139:chemically induced; D011605:Psychoses, Substance-Induced / Q000188:drug therapy / Q000209:etiology*; D016559:Tacrolimus / Q000009:adverse effects*
chemical_list: D014150:Antipsychotic Agents; D007166:Immunosuppressive Agents; D006220:Haloperidol; D016559:Tacrolimus