Steroid induced psychiatric adverse effects: an overview of risk factors, clinical features and management

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dc.contributor.authorParasher, Ananten_US
dc.contributor.authorBez, Jeplinen_US
dc.date.accessioned2020-11-18T10:01:40Z
dc.date.available2020-11-18T10:01:40Z
dc.date.issued2020-06
dc.description.abstractCorticosteroids have been in use since the past five decades as anti-inflammatory and immunosuppressive drugs for the treatment of several pathologies such as asthma, allergy, rheumatoid arthritis, and dermatological disorders. Adverse effects include growth retardation in children, immunosuppression, hypertension, hyperglycemia, inhibition of wound repair, osteoporosis, metabolic disturbances, glaucoma, and cataracts. The psychiatric effects of steroids are due to the wide expression of Glucocorticoid Receptors in the brain, and their long-term modulation can lead to functional and anatomical alterations along with hippocampal dysfunction. In most cases, the psychiatric symptoms disappear on cessation of steroid therapy; others may require some form of therapeutic management. A search was conducted for clinically relevant articles from 1971 to 2016 by including the terms corticosteroids, mania, depression, psychosis and cognitive defects. About one-fifth of patients receiving high doses of corticosteroids develop psychiatric symptoms. These symptoms are observed to be dose-dependent and generally occur during the first few weeks of therapy. Lithium has a preventive as well as therapeutic role, while antipsychotics are reserved for high risk cases with predominant psychotic symptoms. Psychiatric effects of long term steroid therapy have become increasingly common nowadays due to long duration of treatment of many chronic respiratory and orthopedic illnesses. Reduction in the dose or complete discontinuation of steroid therapy has been proven beneficial in many patients. Among the therapeutic options, lithium has a definitive role, both in the prevention as well as treatment of psychiatric symptoms. Better co-ordination between the physician and psychiatrist can go a long way to improve the quality of life in these patients.en_US
dc.identifier.affiliationsDepartment of Medicine, UCMS and GTB Hospital, New Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Psychiatry, Assam Medical College and Hospital, Assam, Indiaen_US
dc.identifier.citationParasher Anant, Bez Jeplin. Steroid induced psychiatric adverse effects: an overview of risk factors, clinical features and management. International Journal of Research in Medical Sciences. 2020 May; 8(5): 2365-2370en_US
dc.identifier.issn2320-6071
dc.identifier.issn2320-6012
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/212297
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber5en_US
dc.relation.volume8en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-6012.ijrms20202296en_US
dc.subjectCognitive deficitsen_US
dc.subjectCorticosteroidsen_US
dc.subjectDepressionen_US
dc.subjectManiaen_US
dc.subjectPsychosisen_US
dc.titleSteroid induced psychiatric adverse effects: an overview of risk factors, clinical features and managementen_US
dc.typeJournal Articleen_US
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