Document Detail


Corticosteroid-induced adverse psychiatric effects: incidence, diagnosis and management.
MedLine Citation:
PMID:  10672894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Reports of corticosteroid-induced adverse psychiatric effects began to appear in the literature soon after the introduction of these medications in the 1950s. Unfortunately, early studies relied on informal classification and measurement procedures and tended to utilise nonspecific descriptive terminology (such as steroid psychosis'). A growing number of contemporary investigations have begun to address these problems. However, the literature remains surprisingly undeveloped from a pharmacoepidemiological perspective, consisting largely of case reports and case series. The objective of this review is to summarise published data concerning corticosteroid-induced adverse psychiatric effects. A clinical perspective will be adopted since opportunities to minimise the impact of corticosteroid-induced adverse effects tend to present themselves most readily within the sphere of clinical management. Some of the psychiatric adverse effects of corticosteroids are mild, and not necessarily clinically significant. However, several serious psychiatric syndromes can be caused by corticosteroids: substance-induced mood disorders (with depressive, manic and mixed features), substance-induced psychotic disorders and delirium. While certain clinical groups may be at greater risk of corticosteroid-induced adverse psychiatric effects, corticosteroid-induced psychiatric toxicity is remarkably unpredictable. The literature regarding prevention and treatment of corticosteroid-induced adverse psychiatric effects is poorly developed. As a result, the emphasis of this review is on clinical and epidemiological evidence linking specific adverse effects to corticosteroid medications. However, clinical reports do provide some practical guidance for prevention and treatment, and these are summarised as well. A variety of pharmacological strategies for treatment and prevention have been proposed. Education and support also appear to be important, and perhaps neglected.
Authors:
S B Patten; C I Neutel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drug safety : an international journal of medical toxicology and drug experience     Volume:  22     ISSN:  0114-5916     ISO Abbreviation:  Drug Saf     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-02-25     Completed Date:  2000-02-25     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9002928     Medline TA:  Drug Saf     Country:  NEW ZEALAND    
Other Details:
Languages:  eng     Pagination:  111-22     Citation Subset:  IM    
Affiliation:
Department of Community Health Sciences, Faculty of Medicine, The University of Calgary, Alberta, Canada. patten@ucalgary.ca
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / administration & dosage,  adverse effects*
Humans
Psychoses, Substance-Induced / diagnosis,  epidemiology,  etiology*,  therapy
Substance Withdrawal Syndrome / etiology*
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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