How do you manage tacrolimus-related psychosis?  

The mechanism of tacrolimus-related psychosis is unclear, but some papers have suggested that calcineurin (which is involved in the regulation of dopaminergic, glutamatergic, and GABAergic systems and implicated in psychotic disorders) may play a role (1). As a result, antipsychotics are often a mai...

I completely agree with Dr. @Thant. When we have worked with our neurology colleagues on cases of tacrolimus-related psychosis we have also seen case studies of success when transitioning to an extended-release formulation of tacrolimus essentially with the goal of reducing peak levels.Mahaparn et a...