International Journal of Mental Health & PsychiatryISSN: 2471-4372

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Case Report, Int J Ment Health Psychiatry Vol: 1 Issue: 3

Tacrolimus induced Mania with Psychosis - A Case Report

Shailesh Jain*, Yu Hsuan Liao and Duy Li
Department of Psychiatry, Texas Tech Health Science Center, School of Medicine - Permian Basin, Odessa, Texas, USA
Corresponding author : Shailesh Jain MD
MPH, ABDA, Associate Professor, 301 North N Street, Midland, Texas, USA, 79701, 432-620-1046
Fax: 432-620-5837
Received: September 22, 2015 Accepted: November 12, 2015 Published: November 16, 2015
Citation: Jain S, Liao YH, Li D (2015) Tacrolimus induced Mania with Psychosis - A Case Report. Int J Ment Health Psychiatry 1:3. doi:10.4172/2471-4372.1000110


We are reporting a case of tacrolimus (Prograf) induced mania with psychotic features in a 68-year-old woman (Ms. A) with recent treatment for acute lymphoblastic leukemia (ALL). Neurotoxicity and delirium have been reported to occur with the macrolide immune suppressive tacrolimus in hepatic and renal allograph transplantations. In addition, nephrotoxicity and anxiety in renal transplants have been correlated with high trough tacrolimus blood concentrations (normal: 5-15 ng/ml, multi-enzymatic immunoassay). Our case is unique in that mania with psychotic features was noted even with subtherapeutic blood levels of tacrolimus (1.6 ng/ml), which did not respond to initial treatment with olanzapine.

Keywords: Tacrolimus; Mania; Psychosis

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