Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Aug 4;11(2):241-246.
doi: 10.1159/000515048. eCollection 2021 May-Aug.

When Paranoia Comes with the Treatment: Psychosis Associated with Tacrolimus Use

João Machado Nogueira  1 , Maria João Freire  1 , Vanessa Vila Nova  1 , Gustavo Jesus  2   3
Affiliations
Case Reports

When Paranoia Comes with the Treatment: Psychosis Associated with Tacrolimus Use

João Machado Nogueira et al. Case Rep Nephrol Dial. .

Abstract

Tacrolimus is an immunosuppressive drug frequently used in solid organ transplant recipients. This drug has well-documented neuropsychiatric side effects in the literature, although emergence of psychotic symptoms is rare, being only described in a very few case reports. We present a case of a renal transplant recipient with no prior psychiatric history, who developed a severe psychosis secondary to supratherapeutic tacrolimus' blood concentrations. This case highlights the importance of clinical awareness to rare but severe neuropsychiatric effects due to tacrolimus use.

Keywords: Neuropsychiatric side effects; Neurotoxic; Psychosis; Tacrolimus.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

References

    1. Manvizhi S, Mathew BS, Fleming DH, Basu G, John GT. Combined approach with therapeutic drug monitoring and pharmacogenomics in renal transplant recipients. Indian J Nephrol. 2013;23((23)):71–3. - PMC - PubMed
    1. Liu J, Farmer JD, Lane WS, Friedman J, Weissman I, Schreiber SL, et al. Calcineurin is a common target of cyclophilin-cyclosporin A and FKBP-FK506 complexes. Cell. 1991;66((4)):807–15. - PubMed
    1. Staatz CE, Tett SE. Clinical pharmacokinetics and pharmacodynamics of tacrolimus in solid organ transplantation. Clin Pharmacokinet. 2004;43((43)):623–53. - PubMed
    1. Bechstein WO. Neurotoxicity of calcineurin inhibitors: impact and clinical management. Transpl Int. 2000;13((5)):313–26. - PubMed
    1. Nayagam LS, Vijayanand B, Balasubramanian S. Massive pleural effusion in a renal transplant recipient on tacrolimus. Indian J Nephrol. 2014;24((5)):318–20. - PMC - PubMed

Publication types