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Psychiatric complications of treatment with corticosteroids: Review with case report

Psychiatric complications of treatment with corticosteroids: Review with case report Corticosteroids are widely used in modern medicine but can result in troubling psychiatric side‐effects. Physicians and other medical professionals should be aware of the potential for these side‐effects, possible means of prevention, and efficacious treatments. Herein, we review adult case report data published during the past quarter‐century on adverse corticosteroid‐induced psychiatric effects, and present a case of corticosteroid‐induced psychotic depression. PubMed and PsychLit databases were searched using the terms ‘corticosteroids’, ‘steroids’, and the generic names of corticosteroid medications with terms for psychiatric symptoms or syndromes, including psychosis, mania, hypomania, depression, apathy, anxiety, panic, depersonalization, delirium, confusion, hallucinations, delusions, paranoia, cognitive impairment and dementia. Fifty‐five cases and a number of clinical trials investigating the incidence and treatment of these psychiatric symptoms and syndromes were identified. Data on incidence, drug dose, risk factors, course of illness and treatment (when present) were tabulated. We conclude that the cumulative data indicate that psychiatric complications of corticosteroid treatment are not rare and range from clinically significant anxiety and insomnia, to severe mood and psychotic disorders, delirium and dementia. While tapering or discontinuation of the corticosteroid treatment may remedy these adverse side‐effects, psychotropic medications are often required because of the medical necessity of the corticosteroid or the severity of the psychiatric symptom. Further studies are needed to better understand the deleterious psychiatric effects associated with corticosteroids. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Psychiatry and Clinical Neurosciences Wiley

Psychiatric complications of treatment with corticosteroids: Review with case report

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References (137)

Publisher
Wiley
Copyright
Copyright © 2011 Wiley Subscription Services
ISSN
1323-1316
eISSN
1440-1819
DOI
10.1111/j.1440-1819.2011.02260.x
pmid
22003987
Publisher site
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Abstract

Corticosteroids are widely used in modern medicine but can result in troubling psychiatric side‐effects. Physicians and other medical professionals should be aware of the potential for these side‐effects, possible means of prevention, and efficacious treatments. Herein, we review adult case report data published during the past quarter‐century on adverse corticosteroid‐induced psychiatric effects, and present a case of corticosteroid‐induced psychotic depression. PubMed and PsychLit databases were searched using the terms ‘corticosteroids’, ‘steroids’, and the generic names of corticosteroid medications with terms for psychiatric symptoms or syndromes, including psychosis, mania, hypomania, depression, apathy, anxiety, panic, depersonalization, delirium, confusion, hallucinations, delusions, paranoia, cognitive impairment and dementia. Fifty‐five cases and a number of clinical trials investigating the incidence and treatment of these psychiatric symptoms and syndromes were identified. Data on incidence, drug dose, risk factors, course of illness and treatment (when present) were tabulated. We conclude that the cumulative data indicate that psychiatric complications of corticosteroid treatment are not rare and range from clinically significant anxiety and insomnia, to severe mood and psychotic disorders, delirium and dementia. While tapering or discontinuation of the corticosteroid treatment may remedy these adverse side‐effects, psychotropic medications are often required because of the medical necessity of the corticosteroid or the severity of the psychiatric symptom. Further studies are needed to better understand the deleterious psychiatric effects associated with corticosteroids.

Journal

Psychiatry and Clinical Neurosciences – Wiley

Published: Jan 1, 2011

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