Abstract

CASE REPORT ON STEROID INDUCED PSYCHOSIS

Greeshma Hanna Varghese*, Hanna Alexander, Swethalekshmi, Neethu Ros Tom

ABSTRACT

Steroid have been variety of adverse drug reaction such as diabetes, hypertension, peptic ulcers, osteoporosis, weight gain and glaucoma are well known. Despite some well-known side effects, the association of psychiatric disorders with the use of these drugs has not been well established and documented. We describe a case of a 24-year old female with a diagnosis of SLE, who has psychotic symptoms which appear to be induced by steroids. Psychiatric symptoms emerged after steroid therapy and diagnosis of steroid-induced psychosis was made by two different causality scales. After discontinuation of steroid therapy, psychiatric symptoms did not improve. But after four weeks of risperidone treatment, he recovered completely. This article reviews case report of steroid induced psychosis and its risk factors. Female sex, past psychiatric history, prednisone dose of more than 40 mg/day and long-term administration are considered to be the major risk factors for steroid psychosis. Length of treatment, time of day treatment is given, type of corticosteroid preparation used, route, dose used, and dosing interval are also be the risk factors. So physician should consider this fact before prescribing steroid doses and emphasize the need for guidelines regarding steroid utilization.

Keywords: Adverse drug reaction, psychosis, SLE, steroids.