She was started on 60 mg prednisone daily and 81 mg aspirin daily.
Psychiatric complications of steroid use are seen in about 6% of patients on steroids & seem to be dose dependent; psychosis typically occurs at doses of greater than 20 mg
She was seen in follow-up one week later, and she reported that all of her symptoms—including her myalgias, headache, jaw pain and vision changes—had completely resolved. Her only new complaint was difficulty sleeping, but she declined a sleep aid. Labs showed normalized inflammatory markers. At her next office visit a month later, she was found to be emotionally labile with anxiety, pressured speech, suicidal ideation and episodes of events in which laughing and crying would trigger a loss of muscle tone but not consciousness (this was observed in the exam room). She was admitted to the hospital for management of new-onset, steroid-induced mania, depression, anxiety and cataplexy.| ← Previous | | | Next → | Single Page