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Presentation of the steroid psychoses
The Journal of Nervous and Mental Disease
|April 1, 1979
Summary
High-dose prednisone (≥40 mg daily) increases the risk of steroid psychosis, particularly within the first five days of treatment. Phenothiazines effectively treated psychosis, while tricyclic antidepressants worsened symptoms.
Area of Science:
- Psychiatry
- Pharmacology
- Endocrinology
Background:
- Corticosteroid therapy is widely used for various medical conditions.
- Steroid-induced psychosis is a recognized adverse effect of corticosteroid treatment.
- Understanding risk factors and treatment is crucial for patient safety.
Purpose of the Study:
- To investigate the risk factors associated with steroid psychosis.
- To characterize the clinical presentation of steroid-induced psychosis.
- To evaluate the efficacy of different pharmacological treatments for steroid psychosis.
Main Methods:
- Retrospective case series analysis of 14 patients experiencing steroid psychosis.
- Dosage and duration of corticosteroid therapy were recorded.
- Clinical symptoms and treatment responses were documented.
Main Results:
- Patients receiving daily doses of 40 mg of prednisone or equivalent were at higher risk.
- Psychotic reactions were more frequent within the first 5 days of treatment.
- Phenothiazines showed excellent response, while tricyclic antidepressants exacerbated symptoms.
Conclusions:
- Daily prednisone doses of 40 mg or more increase the risk of steroid psychosis.
- Early treatment with phenothiazines is recommended for steroid-induced psychosis.
- Tricyclic antidepressants should be avoided in patients with steroid psychosis.