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Psychiatric complications of treatment with corticosteroids: Review with case report.

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Title: Psychiatric complications of treatment with corticosteroids: Review with case report.
Authors: Kenna, Heather A. (AUTHOR), Poon, Amy W. (AUTHOR), de los Angeles, C. Paula (AUTHOR), Koran, Lorrin M. (AUTHOR)
Source: Psychiatry & Clinical Neurosciences. Oct2011, Vol. 65 Issue 6, p549-560. 12p. 1 Chart.
Subjects: Corticosteroids, Mental illness treatment, Psychotic depression, Risk of delirium, Anxiety
Abstract: Corticosteroids are widely used in modern medicine but can result in troubling psychiatric side-effects. Physicians and other medical professionals should be aware of the potential for these side-effects, possible means of prevention, and efficacious treatments. Herein, we review adult case report data published during the past quarter-century on adverse corticosteroid-induced psychiatric effects, and present a case of corticosteroid-induced psychotic depression. PubMed and PsychLit databases were searched using the terms 'corticosteroids', 'steroids', and the generic names of corticosteroid medications with terms for psychiatric symptoms or syndromes, including psychosis, mania, hypomania, depression, apathy, anxiety, panic, depersonalization, delirium, confusion, hallucinations, delusions, paranoia, cognitive impairment and dementia. Fifty-five cases and a number of clinical trials investigating the incidence and treatment of these psychiatric symptoms and syndromes were identified. Data on incidence, drug dose, risk factors, course of illness and treatment (when present) were tabulated. We conclude that the cumulative data indicate that psychiatric complications of corticosteroid treatment are not rare and range from clinically significant anxiety and insomnia, to severe mood and psychotic disorders, delirium and dementia. While tapering or discontinuation of the corticosteroid treatment may remedy these adverse side-effects, psychotropic medications are often required because of the medical necessity of the corticosteroid or the severity of the psychiatric symptom. Further studies are needed to better understand the deleterious psychiatric effects associated with corticosteroids. [ABSTRACT FROM AUTHOR]
Copyright of Psychiatry & Clinical Neurosciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Psychiatric complications of treatment with corticosteroids: Review with case report.
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  Data: <searchLink fieldCode="AR" term="%22Kenna%2C+Heather+A%2E%22">Kenna, Heather A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Poon%2C+Amy+W%2E%22">Poon, Amy W.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22de+los+Angeles%2C+C%2E+Paula%22">de los Angeles, C. Paula</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Koran%2C+Lorrin+M%2E%22">Koran, Lorrin M.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psychiatry+%26+Clinical+Neurosciences%22">Psychiatry & Clinical Neurosciences</searchLink>. Oct2011, Vol. 65 Issue 6, p549-560. 12p. 1 Chart.
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  Data: <searchLink fieldCode="DE" term="%22Corticosteroids%22">Corticosteroids</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+illness+treatment%22">Mental illness treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Psychotic+depression%22">Psychotic depression</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+of+delirium%22">Risk of delirium</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink>
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  Data: Corticosteroids are widely used in modern medicine but can result in troubling psychiatric side-effects. Physicians and other medical professionals should be aware of the potential for these side-effects, possible means of prevention, and efficacious treatments. Herein, we review adult case report data published during the past quarter-century on adverse corticosteroid-induced psychiatric effects, and present a case of corticosteroid-induced psychotic depression. PubMed and PsychLit databases were searched using the terms 'corticosteroids', 'steroids', and the generic names of corticosteroid medications with terms for psychiatric symptoms or syndromes, including psychosis, mania, hypomania, depression, apathy, anxiety, panic, depersonalization, delirium, confusion, hallucinations, delusions, paranoia, cognitive impairment and dementia. Fifty-five cases and a number of clinical trials investigating the incidence and treatment of these psychiatric symptoms and syndromes were identified. Data on incidence, drug dose, risk factors, course of illness and treatment (when present) were tabulated. We conclude that the cumulative data indicate that psychiatric complications of corticosteroid treatment are not rare and range from clinically significant anxiety and insomnia, to severe mood and psychotic disorders, delirium and dementia. While tapering or discontinuation of the corticosteroid treatment may remedy these adverse side-effects, psychotropic medications are often required because of the medical necessity of the corticosteroid or the severity of the psychiatric symptom. Further studies are needed to better understand the deleterious psychiatric effects associated with corticosteroids. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychiatry & Clinical Neurosciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/j.1440-1819.2011.02260.x
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      – SubjectFull: Risk of delirium
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              Text: Oct2011
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