title: Manic-like psychosis associated with elevated trough tacrolimus blood concentrations 17 years after kidney transplant.
abstract: Several neurological side effects induced by tacrolimus are described in the scientific literature, ranging from mild neurological symptoms to delirium and psychosis. We report the case of a 46-year-old man with no prior psychiatric history who suddenly manifested manic-like psychosis associated with elevated trough tacrolimus blood concentrations 17 years after kidney transplant. The use of antipsychotics may improve the severity of symptoms; but in order to obtain a complete remission, the reduction in the dose of tacrolimus, or its replacement with alternative immunosuppressant therapies, is recommended.
authors.affiliation: Department of Medical-Surgical Sciences and Biotechnologies, UOD Fiorini Hospital, Sapienza University of Rome, Viale dell'Universitá No. 30, 00185 Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bersani
authors.forename: Pietropaolo
authors.initials: P
authors.lastname: Marino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Valeriani
authors.forename: Valentina
authors.initials: V
authors.lastname: Cuoco
authors.forename: Claudia
authors.initials: C
authors.lastname: Zitelli
authors.forename: Claudia
authors.initials: C
authors.lastname: Melcore
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Bersani