Mood disorder induced by prednisolone – an easily overlookedcomplication

Authors

DOI:

https://doi.org/10.2478/cpp-2020-0012

Keywords:

corticosteroid, mood disorder, side effect

Abstract

Objective: The use of corticosteroids might be associated with the sequelae of psychiatric comorbidity – manic and depressive symptoms, psychosis, and cognitive impairment.

Case report: We report a case of the 35 years old man who presented seven months period of irritability, occasional low mood, and sleep disturbances without the concurrent hallucinations or delusions. The patient had a history of nephrotic syndrome and for this reason, required prednisolone. The corticosteroid induced irritability that has appeared three months after the treatment has started. The psychiatric examination showed neither the psychomotor retardation, manic or depressed mood, nor hallucinations and delusions. However, the level of irritability was undoubtedly increased.

Conclusions: Corticosteroids are drugs commonly used in many systemic diseases. During a psychiatric examination, a careful evaluation is necessary to distinguish the side effects of corticosteroids from the primary psychiatric disorders.

References

1. Rosenblat JD, Cha DS, Mansur RB, McIntyre RS. Inflamed moods: a review of the interactions between inflammation and mood disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2014;53:23-34.

2. Wada K, Yamada N, Suzuki H, Kuroda S. Recurrent cases of corticosteroid-induced mood disorder: clinical characteristics and treatment. The Journal of clinical psychiatry. 2000;61(4):261-7.

3. Ciriaco M, Ventrice P, Russo G, Scicchitano M, Mazzitello G, Scicchitano F, Russo E. Corticosteroid-related central nervous system side effects. Journal of pharmacology & pharmacotherapeutics. 2013;4:S94.

4. Judd LL, Schettler PJ, Brown ES, Wolkowitz OM, Sternberg EM, Bender BG, Bulloch K, Cidlowski JA, Ronald de Kloet E, Fardet L, Joëls M. Adverse consequences of glucocorticoid medication: psychological, cognitive, and behavioral effects. American Journal of Psychiatry. 2014;171(10):1045-51.

5. Bhangle SD, Kramer N, Rosenstein ED. Corticosteroidinduced neuropsychiatric disorders: review and contrast with neuropsychiatric lupus. Rheumatology international. 2013;33(8):1923-32.

6. Lotan I, Fireman L, Benninger F, Weizman A, Steiner I. Psychiatricsideeffectsofacute high-dose corticosteroidtherapy in neurologicalconditions. International clinicalpsychopharmacology. 2016;31(4):224-31.

7. Campbell R, Tycon L, Pruskowski J. Corticosteroid-Induced Psychiatric Symptoms# 323. Journal of palliative medicine. 2017;20(3):298-9.

8. Hall RC, Popkin MK, Stickney SK, Gardner ER. Presentation of the steroid psychoses. The Journal of nervous and mental disease. 1979;167(4):229-36.

9. Falk WE, Mahnke MW, Poskanzer DC. Lithium Prophylaxis of Corticotropin-lnduced Psychosis. JAMA. 1979;241(10):1011-2.

10. Wyszynski AA, Wyszynski B. Treatment of depression with fluoxetine in corticosteroid-dependent central nervous system Sjögren's syndrome. Psychosomatics. 1993;34(2):173-7.

11. Brown ES, Khan DA, Suppes T. Treatment of corticosteroid induced mood changes with olanzapine. American Journal of Psychiatry. 1999;156(6):968.

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Published

2021-11-29