Rapid-Onset Steroid-Induced Psychosis

Area of Science:

• Neurology
• Psychiatry
• Pharmacology

Background:

• Steroid-induced psychosis is a recognized adverse effect of corticosteroid therapy.
• The typical onset is several days after steroid initiation.

Observation:

• A 91-year-old male patient experienced severe left lateral recess spinal canal stenosis.
• He was prescribed a prednisone taper for his condition.

Findings:

• The patient developed steroid-induced psychosis unusually rapidly, within one day of starting prednisone.
• This occurred at a prednisone dosage not commonly associated with this side effect.

Implications:

• Highlights the potential for rapid onset of steroid-induced psychosis, particularly in elderly patients.
• Emphasizes the need for careful monitoring of older patients with comorbidities when initiating steroid therapy.
• Suggests that patient-specific factors may influence steroid metabolism and adverse event risk.