Suicide Associated with Corticosteroid Use During Chemotherapy: Case Report

Abstract

Corticosteroids are widely known to have a variety of adverse mental effects. Although corticosteroids are frequently used to prevent vomiting induced by chemotherapeutic agent, their mental effects have received little attention in oncology settings. We report the case of a patient who experienced severe depressive symptoms after both the first and second course of treatment with a corticosteroid during chemotherapy and ultimately committed suicide. The temporal and dose-response relationships suggested a possible association between the depressive symptoms and corticosteroid. We ultimately speculated that corticosteroid withdrawal induced the depressive symptoms in this case. This case should alert clinical oncologists to pay attention to mental symptoms after prescribing a corticosteroid.

Trends in incidence and associated risk factors of suicide mortality in patients with non‐small cell lung cancer

“…Moreover, details of treatment to NSCLC were not taken in, and we only know whether patients have undergone surgery and radiation or not. Details of treatment such as the time after surgery and chemotherapy may be associated with suicide of cancer patient 3. Furthermore, our study can't obtain suicide attempts data of NSCLC patients, and patients potential to suicide were likely to be underestimated.…”

“…Several studies have also demonstrated that the suicide rate of cancer patients is twice that of general population 2, 3, 4, 5, 6. Notably, when considering different anatomic cancer sites, patients diagnosed with lung cancer had a higher suicide rate than those with other cancer, with a standardized mortality ratio of 5.74 2.…”

Corticothérapie prolongée et troubles anxieux et dépressifs. Étude longitudinale sur 12mois

“…Dans notre contexte, une jeune patiente de 22 ans, suivie pour pyoderma gangrenosum et mise sous corticothérapie au long cours à la dose de 2 mg/kg par jour, a présenté une dépression sévère avec deux tentatives de suicide médica-menteuses dont une avait nécessitée une prise en charge au service de réanimation, l'évolution de cette patiente était favorable sous traitement ISRS et anxiolytique. Notre cas rapporté correspond à quelques rapports de cas récents cités dans la littérature, notamment celui publié par Yoshihisa M et al [6] décrivant le cas d'un patient, suivi en oncologie, et qui a présenté une dépression sévère avec un suicide suite à une corticothérapie pendant une cure de chimiothérapie.…”

“…Les troubles dépressifs sont plus fréquents au cours de la corticothérapie prolongée, leur prévalence est trois fois plus élevée chez les sujets traités par corticoïdes par rapport aux sujets non traités [5], ces troubles sont parfois très graves, et pouvant être compliqués par un risque suicidaire important [6].…”

Psychiatric sequelae of corticosteroid use in hematology in Australia: A qualitative study

“…Adverse physiological and psychiatric side‐effects occur, and although attention has mainly focused on the physiological, the most common psychiatric disturbances are affective symptoms, with 28% experiencing mild‐to‐moderate and 6% experiencing severe reactions (Warrington & Bostwick, ). Psychiatric side‐effects include mild insomnia, anxiety, irritability, agitation, mood lability, mania, depression, suicidality, and psychosis, (Dubovsky et al, 2012; Fardet, Kassar, Cabane, & Flahaul, ; Fardet, Petersen, & Nazareth, ; Kenna, Poon, de los Angeles, & Koran, ; Matsumoto, Shimizu, Kinoshita, Shimizu, & Uchitomi, ; Ross & Cetas, ). Patients with cancer can develop delirium‐like effects from steroids, often in combination with complex treatment regimens, disease manifestation, and interaction of opiate medications (Dietrich, Rao, Pastorino, & Kesari, ).…”