Corticosteroid-Induced Psychotic and Mood Disorders: Diagnosis Defined by DSM-IV and Clinical Pictures

Wada, Ken; Yamada, Norihito; Sato, Toshiki; Suzuki, Hiroshi; Miki, Masahito; Lee, Yomei; Akiyama, Kazufumi; Kuroda, Shigetoshi

doi:10.1176/appi.psy.42.6.461

Cited by 120 publications

(102 citation statements)

References 19 publications

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“…Testosterone levels are also inversely correlated to the incidence of negative symptoms in schizophrenia and to the poverty of clinical outcome (Akhondzadeh et al, 2006;Goyal et al, 2004). The participation of other NSs, such as glucocorticoids, in the effects of 5AR inhibitors cannot be completely ruled out, in view of their major role in stress and psychosis (Wada et al, 2001). This possibility, however, is partially challenged by preliminary clinical observations, reporting that FIN does not significantly alter circulating cortisol levels (Rittmaster et al, 1994;Uygur et al, 1998).…”

Section: -A-reductase Inhibitors In Models Of Psychosis M Bortolato mentioning

confidence: 99%

Antipsychotic-Like Properties of 5-α-Reductase Inhibitors

Bortolato

Frau

Orrù

et al. 2008

Neuropsychopharmacol

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Recent evidence indicates that neuroactive steroids may participate in the pathogenesis of schizophrenia spectrum disorders, yet the mechanisms of this involvement are elusive. As 5-a-reductase (5AR) is the rate-limiting enzyme of one of the two major metabolic pathways in brain steroidogenesis, we investigated the effects of its blockade in several rat models of psychotic-like behavior. The 5AR inhibitor finasteride (FIN, 60 or 100 mg/kg, intraperitoneal, i.p.) dose-and time-dependently antagonized prepulse inhibition (PPI) deficits induced by apomorphine (APO, 0.25 mg/kg, subcutaneous, s.c.) and d-amphetamine (AMPH, 5 mg/kg, s.c.), in a manner analogous to haloperidol (HAL, 0.1 mg/kg, i.p.) and clozapine (CLO, 5 mg/kg, i.p.). Similar results were observed with the other 5AR inhibitors dutasteride (DUT, 40 or 80 mg/kg, i.p.) and SKF 105111 (30 mg/kg, i.p.). FIN (60 or 100 mg/kg, i.p.) also reduced hyperlocomotion induced by AMPH (1 or 3 mg/kg, s.c.) and attenuated stereotyped behaviors induced by APO (0.25 mg/kg, s.c.). Nevertheless, FIN (100 mg/kg, i.p.) did not reverse the PPI disruption induced by the N-methyl-d-aspartate receptor antagonist dizocilpine (0.1 mg/kg, s.c.). FIN (60-300 mg/kg, i.p.) induced no catalepsy in either the bar test or the paw test. Our results suggest that 5AR inhibitors elicit antipsychotic-like effects in animals and may be proposed as a putative novel target in the management of psychotic disorders.

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Section: -A-reductase Inhibitors In Models Of Psychosis M Bortolato mentioning

confidence: 99%

Antipsychotic-Like Properties of 5-α-Reductase Inhibitors

Bortolato

Frau

Orrù

et al. 2008

Neuropsychopharmacol

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“…The pathophysiological mechanisms giving rise to the psychiatric symptoms associated with corticosteroid treatment remain unclear. Many probable mechanisms have been proposed like corticosteroid effects on dopaminergic and cholinergic systems, decreases in serotonin release, and toxic effects on hippocampal neurons or on other brain regions [13][14][15]. Clinical Psychiatry neuroimaging finding were consistent with Sheehan's syndrome.…”

Section: Discussionmentioning

confidence: 98%

A Case of Sheehan?s Syndrome Developing Mania Following Low Dose Corticosteroid Therapy

Bhattacharya¹

2015

Clin Psychiatry

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“…If the daily dose of corticosteroid is below 40 mg, the risk is considered to be low; if the dose is between 40 and 80 mg, the risk is considered to be moderate; and if the dose is more than 80 mg, the risk is considered to be high (6). Regardless of the dose, the rate of psychiatric side effects for cortisol is reported to be 5.7% (7). However, neither the dose nor other distinguishing factors can determine the severity of the psychiatric disorder in advance.…”

Section: Discussionmentioning

confidence: 99%