Symptomatic depression after long-term steroid treatment: a case report

Good results of the treatment of mood disturbances and psychoses induced with steroid administration are in agreement with the fact described in literature of serotonin release reduction caused by steroids and possible relationship between depressive and psychotic manifestations and low seretonin level in cerebrospinal fluid. The patient had no head trauma in the past. He denied any loss of consciousness. The patient at the age of six years had type C virus hepatitis which changed into chronic hepatitis with a slight autoimmune component. He received six months oral steroid (prednisone) treatment in 20 mg daily dose resulting in symptomatic depression. The patient was treated by the author with sertraline from low doses up to 150 mg daily. A remission of the depressive illness and OCD was obtained. The author decided to treat the patient with sertraline in view of its high safety in somatic diseases and good tolerance.