Related Experiment Video
Updated: May 18, 2026

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
Published on: January 25, 2016
Iatrogenic Cushing's syndrome with inhaled steroid plus antidepressant drugs
Ozlem Celik1, Mutlu Niyazoglu, Hikmet Soylu
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Cerrahpasa Medical School, University of Istanbul, Istanbul, Turkey. kadioglup@yahoo.com.
Abstract:
Current guidelines recommend the use of inhaled corticosteroids (ICS) for suppression of airway inflammation in patients with asthma. Although it is well known that ICS cause dose-related adrenocortical suppression, it is less known that they can lead to iatrogenic Cushing's syndrome (CS). Fluticasone propionate (FP) is an ICS more potent than beclomethasone and budesonide. FP is metabolized as mediated by cytochrome P450 3A4 in the liver and the gut. Systemic bioactivity of FP can increase with the use of drugs that affect the cytochrome P450. Herein, we report the rapid development of iatrogenic CS in a patient receiving paroxetine and mirtazepine for 12 weeks in addition to inhaled FP.
Related Concept Videos
Cushing Syndrome I: Introduction
Cushing Syndrome II: Pathophysiology
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
COPD: Management Using Bronchodilators and Corticosteroids
Antidepressant Drugs: MAOIs and Other Agents
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids