Fluoxetine and cyclosporine in organ transplantation - Failure to detect significant drug interactions or adverse clinical events in depressed organ recipients

Depression and anxiety disorders are common clinical problems in organ transplant recipients, but there is a paucity of clinical data to inform the selection of psychopharmacologic treatment. The authors retrospectively compared 13 depressed organ transplant recipients treated with fluoxetine with 13 nondepressed matched control recipients and 11 transplant recipients treated with tricyclic antidepressants (nortriptyline or desipramine). Blood level:dose ratios and dose-response relationships for cyclosporine were virtually identical in all three groups before and during treatment. No increase in adverse clinical events was detected in either active treatment group compared with the control subjects. Fluoxetine appeared to be well tolerated by this population of transplant patients, and the authors failed to detect significant alterations in cyclosporine levels or graft function.