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Promethazine treatment of steroid-induced psychosis in a child

Dena G Ingram1, Tracy M Hagemann

  • 1College of Pharmacy, University of Oklahoma, Oklahoma City, OK, USA.

The Annals of Pharmacotherapy
|July 5, 2003
PubMed

Insights

Steroid-induced psychosis in a pediatric patient was successfully treated with promethazine, a phenothiazine derivative. This case highlights promethazine as a potential treatment option when corticosteroids cannot be discontinued.

Area of Science:

  • Pediatric Psychology
  • Pharmacology
  • Hematology-Oncology

Background:

  • Corticosteroids are widely used in pediatric medicine, particularly for managing conditions like graft-versus-host disease post-bone marrow transplant.
  • Psychological side effects, including psychosis, are known complications of corticosteroid therapy, though less commonly reported in very young children.

Observation:

  • A 2-year-old boy developed symptoms of steroid-induced psychosis, including mania and agitation, within 24 hours of initiating methylprednisolone for graft-versus-host disease.
  • The patient's underlying condition necessitated continued corticosteroid treatment, precluding immediate discontinuation.

Findings:

  • Promethazine, a phenothiazine derivative, was administered to manage the psychotic symptoms.
  • The patient's psychotic symptoms resolved following the administration of promethazine.

Implications:

  • This case suggests that promethazine may be an effective treatment for steroid-induced psychosis in pediatric patients, especially when corticosteroid cessation is not feasible.
  • Further research into the use of phenothiazine derivatives like promethazine for managing corticosteroid-induced psychiatric effects in young children is warranted.
Abstract

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