Steroid-induced psychiatric syndromes
Abstract
Although it is well-established that psychiatric symptoms can develop in association with the administration of corticosteroids, the nature of this relationship is poorly understood. We reviewed 14 previously unreported cases of steroid-induced psychiatric syndromes, 79 cases from the literature and 29 studies of the clinical efficacy of steroids in various medical illnesses. Our findings indicate that severe psychiatric reactions occur in approximately 5% of steroid-treated patients, and that a large proportion of these patients have affective and/or psychotic symptoms. Psychiatric disturbances usually occur early in the course of steroid therapy. Female sex, systemic lupus erythematosus and high doses of prednisone may be risk factors for the development of a steroid-induced psychiatric syndrome. Treatment with steroid-taper, neuroleptics or electroconvulsive therapy is generally effective, although tricyclic antidepressants do not appear to be useful therapeutic agents. Most patients recover within several weeks of the onset of symptoms.
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Elevated corticosteroids increase the liability for affective illness.
“although elevated corticosteroids increase although elevated corticosteroids increase the liability for affective illness (Lewis & the liability for affective illness (Lewis & Smith, 1983).”
From Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents (2000) · cites this paper as Lewis & Smith, 1983
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- Authors
- Lewis, D. A., & Smith, R. E.
- Affiliations
- University of Iowa Hospitals and Clinics (US)
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 1983-11
- Volume
- 5
- Issue
- 4
- Pages
- 319-332
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2054927681
- Cited by
- 528
- References
- 0
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 11 · 2023: 16 · 2022: 17 · 2021: 32 · 2020: 39 · 2019: 15 · 2018: 12 · 2017: 12 · 2016: 15 · 2015: 25 · 2014: 12 · 2013: 17 · 2012: 24
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- corticosteroid adverse effects, prednisone, systemic lupus erythematosus, mood disorders, psychosis, corticosteroid tapering, antipsychotic drugs, electroconvulsive therapy, tricyclic antidepressants, risk factors
- MeSH terms
- Adolescent, Adrenal Cortex Hormones, Adrenocorticotropic Hormone, Adult, Aged, Mental Disorders, Bipolar Disorder, Child, Child, Preschool, Delirium, Depressive Disorder, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Psychoses, Substance-Induced, Risk
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