Treatment-Refractory Mania with Psychosis in a Post-Transplant Patient on Tacrolimus: A Case Report

Clin Med Res. 2018 Jun;16(1-2):47-49. doi: 10.3121/cmr.2018.1409. Epub 2018 May 18.

Abstract

Bipolar affective disorder type I imparts significant morbidity and disease burden in the population. It is characterized by occurrence of one or more manic episodes which may be preceded or followed by a depressive or hypomanic phase. About half of these manic episodes are characterized by the presence of psychotic features. The condition is further complicated when the patient has multiple comorbid conditions. We report here the case of a Caucasian woman, aged 66 years, previously diagnosed with Bipolar disorder who developed treatment refractory mania with psychotic feature after being on the immunosuppressive agent, tacrolimus, after kidney transplantation.

Keywords: Bipolar affective disorder; Psychosis; Renal transplant; Tacrolimus; Treatment resistance.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antipsychotic Agents / therapeutic use
  • Bipolar Disorder / chemically induced*
  • Bipolar Disorder / drug therapy
  • Female
  • Graft Rejection / prevention & control*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation*
  • Mycophenolic Acid / therapeutic use
  • Prednisone / therapeutic use
  • Psychoses, Substance-Induced / drug therapy
  • Psychoses, Substance-Induced / etiology*
  • Psychotic Disorders
  • Severity of Illness Index
  • Tacrolimus / adverse effects*

Substances

  • Antipsychotic Agents
  • Immunosuppressive Agents
  • Mycophenolic Acid
  • Prednisone
  • Tacrolimus