title: Neurobehavioral consequences of small molecule-drug immunosuppression.
abstract: 60 years after the first successful kidney transplantation in humans, transplant patients have decent survival rates owing to a broad spectrum of immunosuppressive medication available today. Not only transplant patients, but also patients with inflammatory autoimmune diseases or cancer benefit from these life-saving immunosuppressive and anti-proliferative medications. However, this success is gained with the disadvantage of neuropsychological disturbances and mental health problems such as depression, anxiety and impaired quality of life after long-term treatment with immunosuppressive drugs. So far, surprisingly little is known about unwanted neuropsychological side effects of immunosuppressants and anti-proliferative drugs from the group of so called small molecule-drugs. This is partly due to the fact that it is difficult to disentangle whether and to what extent the observed neuropsychiatric disturbances are a direct result of the patient's medical history or of the immunosuppressive treatment. Thus, here we summarize experimental as well as clinical data of mammalian and human studies, with the focus on selected small-molecule drugs that are frequently employed in solid organ transplantation, autoimmune disorders or cancer therapy and their effects on neuropsychological functions, mood, and behavior. These data reveal the necessity to develop immunosuppressive and anti-proliferative drugs inducing fewer or no unwanted neuropsychological side effects, thereby increasing the quality of life in patients requiring long term immunosuppressive treatment. This article is part of a Special Issue entitled 'Neuroimmunology and Synaptic Function'.
authors.affiliation: Institute of Medical Psychology and Behavioral Immunobiology, University Hospital, Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. Electronic address: katharina.boesche@uk-essen.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Bösche
authors.affiliation: Department of Neurology, Hannover Medical School, 30625 Hannover, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Weissenborn
authors.affiliation: Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
authors.forename: Uwe
authors.initials: U
authors.lastname: Christians
authors.affiliation: Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Witzke
authors.affiliation: Institute of Medical Psychology and Behavioral Immunobiology, University Hospital, Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Engler
authors.affiliation: Institute of Medical Psychology and Behavioral Immunobiology, University Hospital, Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Schedlowski
authors.affiliation: Institute of Medical Psychology and Behavioral Immunobiology, University Hospital, Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. Electronic address: martin.hadamitzky@uk-essen.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Hadamitzky
mesh_terms: D000818:Animals; D001921:Brain / Q000187:drug effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects* / Q000523:psychology*; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D001523:Mental Disorders / Q000139:chemically induced*
chemical_list: D007166:Immunosuppressive Agents
keywords: Affective disorders; Anxiety; Depression; Immunotherapeutic drugs; Neuropsychiatric complications