Mood and Cognitive Changes During Systemic Corticosteroid Therapy

Abstract

BACKGROUND: Physicians in the United States write approximately 10 million new prescriptions for oral corticosteroids each year. Common side effects of corticosteroids include weight gain, osteoporosis, and diabetes mellitus. This article reviews the available literature on psychiatric and cognitive changes during corticosteroid therapy. METHOD: A search of the MEDLINE and psycINFO databases was conducted to find clinically relevant articles on psychiatric and cognitive side effects with corticosteroids using search terms including corticosteroid, prednisone, mania, depression, psychosis, mood, memory, and cognition. RESULTS: Symptoms of hypomania, mania, depression, and psychosis occur during corticosteroid therapy as do cognitive changes, particularly deficits in verbal or declarative memory. Psychiatric symptoms appear to be dose-dependent and generally occur during the first few weeks of therapy. Patients who must remain on corticosteroids may benefit from pharmacotherapeutic approaches, such as lithium and the new antipsychotic medications. CONCLUSION: Mood and cognitive changes with corticosteroids appear to be common but generally mild and reversible side effects. More studies are needed to determine effective treatment for steroid-induced psychiatric disorders.

Risperidone treatment in a steroid-induced psychosis case / Steroid ile tetiklenen bir psikoz olgusunda risperidon tedavisi

“…The efficiency of valproate as a prophylactic agent against steroid-induced psychosis has also been documented (14). Although mood stabilizers such as lithium and valproate appear to be effective, carbamazepine should probably be avoided as this medication induces the metabolism of some steroids, potentially lowering plasma levels of them and increasing the symptoms of the underlying disease process (15).…”

Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management

“…73 Psychiatric outcomes such as mania are more likely to occur early in treatment, potentially within the first week of therapy. 61,74 Depressive symptoms typically occur later in the course of treatment or may be evident during the tapering phase of therapy.…”

Ignored Complication of Steroids in an Ankylosing Spondylitis Case: Psychotic Depression

“…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).…”