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Prednisolone psychosis: clinical observations
Drug Intelligence & Clinical Pharmacy
|July 1, 1984
Summary
Corticosteroid-induced psychosis can occur within ten days of treatment, often in women, presenting as manic or depressive episodes with hallucinations. Higher doses exponentially increase the risk of these mental disturbances.
Area of Science:
- Neuropsychiatry
- Pharmacology
- Endocrinology
Background:
- Corticosteroids, like prednisolone, are widely used for their anti-inflammatory and immunosuppressive properties.
- Adverse psychiatric effects associated with corticosteroid therapy are a recognized clinical concern.
- Understanding the specific risks and presentation patterns is crucial for patient safety.
Observation:
- Three Chinese patients developed acute psychosis while receiving daily doses of prednisolone (15-75 mg/d).
- The observed mental disturbances included acute manic or depressive episodes.
- Symptoms frequently involved delusions and/or hallucinations.
Findings:
- Corticosteroid-induced mental disturbances typically manifest within the first ten days of treatment.
- Women appear to be more frequently affected by these psychiatric side effects.
- A dose-dependent relationship exists, with risk increasing exponentially as corticosteroid dosage rises.
Implications:
- Early recognition of psychiatric symptoms is vital for patients on corticosteroid therapy.
- Clinicians should consider dose reduction or discontinuation if psychosis develops.
- Further research into risk factors and preventative strategies for corticosteroid-induced psychosis is warranted.