Steroid Psychosis: A Case Series of Three Patients

Abstract

Background: Steroids are widely used in modern medicine for the treatment of various ailments. Steroid psychosis is a known complication of steroid therapy, although infrequent. Herein we describe a series of three cases where patients presented with pure psychosis without mood disturbance, which is highly unlikely, following steroid therapy. Cases: Two female and one male patients aged 23 years, 50 years and 80 years respectively developed psychosis following steroid administration. In the first case, oral methylprednisolone (48 mg/day) was used in the management of systemic lupus erythematosus, second case received intravenous dexamethasone (36 mg/day) for the management of bronchopneumonia, while third case had a two day course of intravenous methylprednisolone (120 mg/day) for the treatment of chronic obstructive pulmonary disease. Conclusion: Consistent with the previous studies, female gender and high steroid dose were identified as the common risk factors for the development of steroid psychosis. Steroid psychosis is a major complication, which if recognized early can be effectively treated. Treatment with high dose of steroids should be used cautiously to avoid psychotic adverse reactions.

Vasculitis and Steroid Psychosis: A Case Report and Review of Literature

“…Other risk factors for the development of CC-associated psychosis are female gender, hypoalbuminemia, and drugs that increase circulating levels of CC, such as inhibitors of the cytochrome P450 enzyme. A history of psychiatric illness does not condition a risk factor, nor does any specific age group seem to be at increased risk [ 5 ]. Psychiatric disorders may occur at any time during treatment, including almost immediately after initiation and even after cessation of CC [ 2 ].…”