Which of the following prophylactic agents used in patients after allogeneic stem cell transplant is most commonly associated with neuropsychiatric side effects?
The correct answer is A. Acyclovir (active vs HSV-1, HSV-2, VZV) has been rarely associated with neurologic toxicity including agitation, tremors, delirium, hallucinations, and myoclonus, mostly in patients with underlying renal impairment. Of note, acyclovir is renally cleared but some cases of toxicity have occurred even after appropriate dose adjustment for renal function.
Publication reference : Brandariz-Nunez D et al. Neurotoxicity associated with acyclovir and valacyclovir: A systematic review of cases. J Clin Pharm Ther 2021; 46: 918-926 Reference URL:https://pubmed.ncbi.nlm.nih.gov/34146428/