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The neuropsychiatric sequelae of corticosteroid use: identification and management considerations

Published online by Cambridge University Press:  26 September 2025

Oriana Bezzina Open the ORCID record for Oriana Bezzina [Opens in a new window]  and
Vishaal Goel
Oriana Bezzina*
Affiliation:
A higher trainee (Specialty Trainee Year 6, ST6) in general adult psychiatry working in Sunderland Royal Hospital’s Psychiatric Liaison Team within Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Sunderland, UK. She is interested in medical education and is undertaking a review looking into interventions to improve undergraduate medical student well-being.
Vishaal Goel
Affiliation:
A consultant psychiatrist working in Sunderland Royal Hospital’s Psychiatric Liaison Team within Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Sunderland, UK. He also works in independent practice as medical director and consultant psychiatrist for Integra Psychiatry (www.integrapsychiatry.com).
*
Correspondence Oriana Bezzina. Email: o.bezzina@nhs.net
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Summary

This article is a concise refreshment for psychiatrists to update their knowledge and understanding of corticosteroid-induced psychiatric symptoms. It summarises the diverse presentation associated with this clinical phenomenon, how frequently it occurs and some pathophysiological considerations. There is a focus on early identification and management, highlighting the importance of an integrated multidisciplinary approach, withdrawal or reduction of the corticosteroid treatment and adjunctive psychotropic medication options for clinicians to consider.

Keywords

Liaison psychiatrydrug or substance interactions and side-effectscomorbiditygeneral adult psychiatryold age psychiatry

Information

Type
Refreshment
Information
BJPsych Advances , First View , pp. 1 - 2
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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References

Gagliardi, JP, Muzyk, AJ, Holt, S (2010) When steroids cause psychosis. The Rheumatologist, 4(Oct).Google Scholar
Goel, V (2025) Case 29. In Oxford Case Histories Palliative Medicine (eds Pickard, J, Hindmarsh, J): 267–75. Oxford University Press.Google Scholar
Huynh, G, Reinert, JP (2020) Pharmacological management of steroid-induced psychosis: a review of patient cases. Journal of Pharmacy Technology, 37: 120–6.10.1177/8755122520978534CrossRefGoogle ScholarPubMed
Lu, Y, Ann, L, McCarron, R (2021) Steroid-induced psychiatric symptoms: what you need to know. Current Psychiatry, 20: 33–8.Google Scholar
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