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Neuropharmacology. 2015 Sep;96(Pt A):83-93. doi: 10.1016/j.neuropharm.2014.12.008. Epub 2014 Dec 19.

Neurobehavioral consequences of small molecule-drug immunosuppression.

Author information

1
Institute of Medical Psychology and Behavioral Immunobiology, University Hospital, Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. Electronic address: katharina.boesche@uk-essen.de.
2
Department of Neurology, Hannover Medical School, 30625 Hannover, Germany.
3
Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
4
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany.
5
Institute of Medical Psychology and Behavioral Immunobiology, University Hospital, Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany.
6
Institute of Medical Psychology and Behavioral Immunobiology, University Hospital, Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. Electronic address: martin.hadamitzky@uk-essen.de.

Abstract

60 years after the first successful kidney transplantation in humans, transplant patients have decent survival rates owing to a broad spectrum of immunosuppressive medication available today. Not only transplant patients, but also patients with inflammatory autoimmune diseases or cancer benefit from these life-saving immunosuppressive and anti-proliferative medications. However, this success is gained with the disadvantage of neuropsychological disturbances and mental health problems such as depression, anxiety and impaired quality of life after long-term treatment with immunosuppressive drugs. So far, surprisingly little is known about unwanted neuropsychological side effects of immunosuppressants and anti-proliferative drugs from the group of so called small molecule-drugs. This is partly due to the fact that it is difficult to disentangle whether and to what extent the observed neuropsychiatric disturbances are a direct result of the patient's medical history or of the immunosuppressive treatment. Thus, here we summarize experimental as well as clinical data of mammalian and human studies, with the focus on selected small-molecule drugs that are frequently employed in solid organ transplantation, autoimmune disorders or cancer therapy and their effects on neuropsychological functions, mood, and behavior. These data reveal the necessity to develop immunosuppressive and anti-proliferative drugs inducing fewer or no unwanted neuropsychological side effects, thereby increasing the quality of life in patients requiring long term immunosuppressive treatment. This article is part of a Special Issue entitled 'Neuroimmunology and Synaptic Function'.

KEYWORDS:

Affective disorders; Anxiety; Depression; Immunotherapeutic drugs; Neuropsychiatric complications

[Indexed for MEDLINE]

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