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Calcineurin inhibitor–induced psychosis

Current Psychiatry. 2021 November;20(11):43-45 | doi: 10.12788/cp.0186
October 29, 2021|Psychiatry
Michael Diduch, PharmD, BCPP;Leo Batongbakal, PharmD;Tracy Martin, MD;Ritu Chandak, MD
Author and Disclosure Information

Dr. Diduch is Medical Science Liaison, Indivior, Richmond, Virginia. Dr. Batongbakal is a PGY-1 Pharmacy Practice Resident, Jersey City Medical Center, Jersey City, New Jersey. Dr. Martin is a PGY-3 Psychiatry Resident, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey. Dr. Chandak is a Psychiatrist, Jersey City Medical Center, Jersey City, New Jersey. 

Disclosures

The authors report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products. The views expressed in this article are those of the authors alone, and not of Indivior or any other entity

CASE CONTINUED

Mrs. C is admitted to the inpatient psychiatric unit and started on risperidone, 1 mg twice daily. Initially, she complains of lightheadedness at night due to the risperidone, so her dose is changed to 2 mg at bedtime. Gradually, she begins to show mild improvement. Previously, she reported feeling frightened of staff members, but after a few days she reports that she feels safe at the hospital. However, her delusions of being monitored by the FBI persist.

After 9 days of hospitalization, Mrs. C is discharged home to the care of her daughter. At first, she does well, but unfortunately she begins to refuse to take her medication and returns to her baseline.

Related Resources

  • Gok F, Eroglu MZ. Acute psychotic disorder associated with immunosuppressive agent use after renal transplantation: a case report. Psychiatry and Clinical Psychopharmacology. 2017;3:314-316.
  • Bersani G, Marino P, Valerani G, et al. Manic-like psychosis associated with elevated trough tacrolimus blood concentrations 17 years after kidney transplant. Case Rep Psychiatry. 2013;2013:926395. doi: 10.1155/2013/926395

Drug Brand Names

Amlodipine • Norvasc

Aripiprazole • Abilify

Atorvastatin • Lipitor

Benztropine • Cogentin

Cinacalcet • Sensipar

Cyclosporine • Gengraf

Haloperidol • Haldol

Ketamine • Ketalar

Levothyroxine • Synthroid

Metformin • Glucophage

Mycophenolate mofetil • CellCept

Olanzapine • Zyprexa

Quetiapine • Seroquel

Paliperidone • Invega

Risperidone • Risperdal

Tacrolimus • Prograf

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