Mania Associated With Supratherapeutic Tacrolimus Levels in a Patient With No Psychiatric History

Aripiprazole Augmentation of Low-Dose Sertraline Therapy Induced Hypomania in a Liver Transplantation Recipient: A Case Report

“…10–12 Supratherapeutic tacrolimus level is associated with mania. 13 As tacrolimus level can be varied with telaprevir, a substrate of both CYP3A4 and P-glycoprotein, 14 low-dose aripiprazole may also have similar effect and cause hypomanic/manic symptom. The patient who received ECT also received venlafaxine, 4 a substrate of P-glycoprotein and was reported to have increased 5-HT effect, causing toxic symptoms when administered with tacrolimus.…”