Rare Case of Acute Psychotic Disorder Associated with Immunosuppressant Medications Use After Kidney Transplantation.

Renal transplantation is the treatment of choice for patients with end-stage renal failure as it provides patients with the best quality of life because of its survival benefits, either short or long-term. However, despite the benefits of renal transplantation over dialysis, the life-long immunosuppressant treatment needed after kidney transplantation has several drawbacks. The present case developed a psychotic disorder after 8 years of regular intake of immunosuppressant medications tacrolimus and prednisone. He was switched to cyclosporine, and the dose of prednisone was decreased, but he only showed partial improvement in his behavior. The patient was started on the antipsychotic drug risperidone, and the delusions subsided within 12 weeks of starting the medication. This case highlights the importance of clinical awareness of rare but severe psychiatric effects due to immunosuppressant use. In conclusion, early recognition of psychiatric side effects of immunosuppressants and systemic corticosteroids and starting appropriate treatment is essential to prevent more serious psychiatric side effects.