Abstract
Background: Tacrolimus has historically been used as an effective immunosuppressant in solid organ transplants. Although it is standard care in most organ transplants, it is accompanied by a vast number of side effects, including headache, fatigue, and even psychosis. The neurotoxic side effects that accompany tacrolimus are usually apparent at supratherapeutic doses and resolve after dose adjustment or discontinuation. Case Presentation: We present a case of a 68-year-old male who sustained tacrolimus-induced mania post- transplant, refractory to both medication tapering and removal. He ultimately required the use of prolonged antipsychotic therapy. Conclusion: This study highlights the necessity for thorough psychiatric evaluations in patients undergoing organ transplantation as well as the continued need for further research and interventions in patients undergoing prolonged immunosuppressive therapy. This report may signify a novel mechanism of dose-independent neurotoxicity secondary to tacrolimus.
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