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Psychiatric adverse effects of corticosteroids
Thomas P Warrington1, J Michael Bostwick
1Mayo Medical School, Rochester, Minn 55905, USA.
Mayo Clinic Proceedings
|October 14, 2006
Summary
Psychiatric adverse effects are common with systemic corticosteroid therapy. This review outlines identifying and managing these corticosteroid-induced psychiatric syndromes.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Psychiatric adverse effects are common during systemic corticosteroid therapy.
- Severe reactions occur in nearly 6% of patients, with mild to moderate reactions in about 28%.
Purpose of the Study:
- To offer an approach to identifying and managing corticosteroid-induced psychiatric syndromes.
- To base management on symptom type and anticipated corticosteroid treatment duration.
Main Methods:
- Review of existing meta-analyses and clinical data.
- Analysis of psychiatric adverse effect patterns related to corticosteroid therapy.
Main Results:
- Short-term corticosteroid therapy commonly causes euphoria and hypomania.
- Long-term therapy tends to induce depressive symptoms.
- Dosage correlates with incidence but not timing, severity, or duration of effects.
Conclusions:
- Corticosteroid-induced psychiatric symptoms often appear early and resolve with dose reduction or discontinuation.
- Severe cases may require antipsychotics or mood stabilizers.
- Management strategies should consider symptom type and treatment duration.
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