Psychopharmacologic issues in organ transplantation. Part 2: Psychopharmacologic medications

This article reviews psychopharmacology in organ transplant patients, with particular attention to the changes in the metabolism and elimination of drugs during organ insufficiency and drug interactions in the immunosuppressed state. The side effects of psychotropic drugs need to be distinguished from those of immunosuppressants. Antidepressants, including tricyclics, heterocyclics, MAOIs, stimulants, and newer agents, are discussed. Use of neuroleptics for delirium, mania, and other organic disorders is described. Lithium may be more difficult to use in the immediate postoperative period. Anxiolytics, including benzodiazepines and buspirone, are useful depending on the underlying medical problem.