Corticosteroid-induced psychosis can cause psychiatric symptoms such as hypomania, depression, anxiety, and even true psychosis. Treatment options depend on the patient’s condition and why they are taking steroids. Symptoms vary widely, and tapering off the drug or psychotherapy may be necessary. Patients should discuss any unusual mood changes with their doctor, and be aware that psychiatric symptoms can occur at any time.
Corticosteroid-induced psychosis is an adverse reaction to drugs used to treat inflammation, pain, and some chronic immune conditions. These drugs can produce psychiatric symptoms, the most marked of which are a combination of problems such as hypomania, depression and anxiety. Some patients also experience true psychosis, a break with reality that can include paranoid thoughts and hallucinations. Treatment options depend on how the condition presents and why the patient is taking steroids.
Patients taking high doses of corticosteroids, particularly in combination with other drugs or on a long-term basis, may be at increased risk for corticosteroid-induced psychosis. A history of psychiatric problems is not a risk factor, according to numerous studies, and the abnormal psychiatric state is usually temporary, stopping once the patient stops taking the drug and finishes metabolizing it. Some research has suggested that corticosteroids may be associated with the onset of bipolar disorder, but a definitive link has not been established.
Symptoms of corticosteroid-induced psychosis can vary widely between patients. Some may develop hypomania, where they feel very energetic, have trouble sleeping, and may start to feel unstoppable. Other patients may experience depression or mood swings. Anxiety, agitation, and irritability are also signs of steroid-induced psychosis. Hallucinations and false beliefs about the world around the patient may also develop; for example, a patient may believe that medical providers are involved in a conspiracy.
Simply stopping steroids may not be possible, both because they may be needed for treatment and because stopping steroid therapy abruptly can be dangerous. One option for treating corticosteroid-induced psychosis may be tapering if it is possible to safely take the patient off the drug and try another therapy. Psychotherapy may also be considered, along with psychiatric medications. Hospitalization may be necessary if there are concerns about the patient’s health and safety.
Severe cases of corticosteroid-induced psychosis are relatively rare, but can occur. People who begin to notice unusual bursts of energy, sadness, and other strange mood changes on steroids may want to discuss these with the prescribing doctor. An evaluation can determine whether the patient appears to be developing a psychiatric problem and can help make decisions about how to proceed with treatment. For patients who must take long-term medication to treat a chronic condition, it is important to be aware that psychiatric symptoms can occur at any time, although they are more common when starting corticosteroids.
Protect your devices with Threat Protection by NordVPN
