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When Steroids Cause Psychosis

Jane P. Gagliardi, MD, MHS, Andrew J. Muzyk, PharmD, & Shannon Holt, PharmD  |  Issue: October 2010  |  

Dr. Gagliardi is an assistant professor of psychiatry and behavioral sciences and assistant professor of medicine at Duke University School of Medicine in Durham, N.C. Dr. Muzyk is an assistant professor and Dr. Holt is a pharmacy resident at Campbell University School of Pharmacy and Health Sciences in Buies Creek, N.C.

References

  1. Bolanos SH, Khan DA, Hanczyc M, et al. Assessment of mood states in patients receiving long-term corticosteroid therapy and in controls with patient-rated and clinician-rated scales. Ann Allergy Asthma Immunol. 2004;92:500-505.
  2. Sirois F. Steroid psychosis: A review. Gen Hosp Psychiatry. 2003;25:27-33.
  3. Warrington TP, Bostwick JM. Psychiatric adverse effect of corticosteroids. Mayo Clin Proc. 2006;81:1361-1367.
  4. Brown ES, Suppes T, Khan DA, Carmody III TJ. Mood changes during prednisone bursts in outpatients with asthma. J Clinical Psychopharm. 2002;22:55-61.
  5. Brown WA, Johnston R, Mayfield D. The 24-hour dexamethasone suppression test in a clinical setting: Relationship to diagnosis, symptoms, and response to treatment. Am J Psychiatry. 1979;136:543-547.
  6. Naber D, Sand P, Heigl B. Psychopathological and neuropsychological effects of 8-days’ corticosteroid treatment. A prospective study. Psychoneuroendocrinology. 1996; 21:25-31.
  7. Brown ES, Woolston DJ, Frol A, et al. Hippocampal volume, spectroscopy, cognition, and mood in patients receiving corticosteroid therapy. Biol Psychiatry. 2004;55:538-545.
  8. Schatzberg AF, Rothschild AJ, Langlais PJ, et al. A corticosteroid/dopamine hypothesis for psychotic depression and related states. J Psychiatr Res. 1985;19:57-64.
  9. The Boston Collaborative Drug Surveillance Program. Acute adverse reactions to prednisone in relation to dosage. Clin Pharmacol Ther. 1972;13:694-698.
  10. Brown ES, Stuard G, Liggin JD, et al. Effect of phenytoin on mood and declarative memory during prescription corticosteroid therapy. Bio Psychiatry. 2005;57:543-548.
  11. Brown ES, Frol AB, Khan DA, et al. Impact of levetiracetam on mood and cognition during prednisone therapy. Eur Psychiatry. 2007;22:448-452.
  12. Brown ES, Frol A, Bobadilla L, et al. Effect of lamotrigine on mood and cognition in patients receiving chronic exogenous corticosteroids. Psychosomatics. 2003;44:204-208.
  13. Falk WE, Mahnke MW, Poskanzer DC. Lithium prophylaxis of corticotropin-induced psychosis. JAMA. 1979;241:1011-1012.
  14. Goldman LS, Goveas J. Olanzapine treatment of corticosteroid-induced mood disorders. Psychosomatics. 2002; 43:495-497.
  15. Brown ES, Khan DA, Suppes T. Treatment of corticosteroid-induced mood changes with olanzapine. Am J Psychiatry. 1999;156:968.
  16. Brown ES, Chamberlain W, Dhanani N, et al. An open-label trial of olanzapine for corticosteroid-induced mood symptoms. J Affect Disord. 2004;83:277-281.
  17. Budur K, Pozuelo L. Olanzapine for corticosteroid-induced mood disorders. Psychosomatics. 2003;44:353.
  18. Herguner S, Bilge I, Yavuz Yilmaz A, et al. Steroid-induced psychosis in an adolescent: Treatment and prophylaxis with risperidone. Turk J Pediatr. 2006;48:244-247.
  19. DeSilva CC, Nurse MC, Vokey K. Steroid-induced psychosis treated with risperidone. Can J Psychiatry. 2002;47: 388-389.
  20. Kato O, Misawa H. Steroid-induced psychosis treated with valproic acid and risperidone in a patient with systemic lupus erythematosus. Prim Care Companion J Clin Psychiatry. 2005;7:312.
  21. Kramer TM, Cottingham EM. Risperidone in the treatment of steroid-induced psychosis. J Child Adolesc Psychopharmacol. 1999;9:315-316.
  22. Siddiqui Z, Ramaswamy S, Petty F. Quetiapine therapy for corticosteroid-induced mania. Can J Psychiatry. 2005; 50:77-78.
  23. Ahmad M, Rasul FM. Steroid-induced psychosis treated with haloperidol in a patient with active chronic obstructive pulmonary disease [letter]. Am J Emergency Med. 1999;17:735.
  24. Bloch M, Gur E, Shalev A. Chlorpromazine prophylaxis of steroid-induced psychosis. Gen Hosp Psychiatry. 1994; 16:42-44.
  25. Boehm G, Racoosin JA, Laughren TP, Katz R. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care. 2004; 27:596-601.
  26. Siegal FP. Lithium for steroid-induced psychosis. N Engl J Med. 1978;299:155-156.
  27. Goggans FC, Weisberg LJ, Koran LM. Lithium prophylaxis of prednisone psychosis: A case report. J Clin Psychiatry. 1983;44:111-112.
  28. Sabet-Sharghi F, Hutzler JC. Prophylaxis of steroid-induced psychiatric syndromes. Psychosomatics. 1990;31:113-114.
  29. Merrill W. Case 35-1998: Use of lithium to prevent corticosteroid-induced mania. N Engl J Med. 1999;340:1123.
  30. Abbas A, Styra R. Valproate prophylaxis against steroid induced psychosis. Can J Psychiatry. 1994;39:188-189.
  31. Himelhoch S, Haller E. Extreme mood lability associated with systemic lupus erythematosus and stroke successfully treated with valproic acid. J Clin Psychopharmacol. 1996;16:469-470.
  32. Kahn D, Stevenson E, Douglas CJ. Effect of sodium valproate in three patients with organic brain syndromes. Am J Psychiatry. 1998;145:1010-1011.
  33. Wada K, Yamada N, Yamauchi Y, et al. Carbamazepine treatment of corticosteroid-induced mood disorder. J Affect Disord. 2001;65:315-317.
  34. Carlat DJ. The psychiatric review of symptoms: A screening tool for family physicians. Am Fam Phys. 1998;58:1617-1624.
  35. Preda A, Fazeli A, McKay BG, Bowers MB, Mazure CM. Lamotrigine as prophylaxis against steroid-induced mania. J Clin Psychiatry. 1999;60:708-709.
  36. Ginsberg DL, Sussman N. Gabapentin as prophylaxis against corticosteroid-induced mania. Can J Psychiatry. 2001;44:455-456.
  37. Pande AC, Crockatt JG, Janney CA, Werth JL, Tsaroucha G. Gabapentin in bipolar disorder: A placebo-controlled trial of adjunctive therapy. Gabapentin Bipolar Disorder Study Group. Bipolar Disord. 2000; 2:249-255.
  38. Cheer SM, Wagstaff AJ. Quetiapine: A review of its use in the management of schizophrenia. CNS Drugs. 2004;18:173-199.
  39. Bowles TM, Levin GM. Aripiprazole: A new atypical antipsychotic drug. Ann Pharmacother. 2003;37:687-694
  40. Caley CF, Cooper CK. Ziprasidone: The fifth atypical antipsychotic. Ann Pharmacother. 2002;36:839-851
  41. Livingston MG. Risperidone. Lancet 1994;343:457-460.
  42. Fulton B, Goa KL. Olanzapine: A review of its pharmacological properties and therapeutic efficacy in the management of schizophrenia and related psychoses. Drugs. 1997;53:281-298.

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