Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-27T14:06:26.101Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychiatric complications of corticosteroids in older people

Published online by Cambridge University Press:  13 June 2014

Aideen Freyne
Aideen Freyne*
Affiliation:
St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

The neuropsychiatric effects of corticosteroids are well described in the literature but relatively little is known specifically about their effects among older people. As the population ages, and increasing numbers of older people receive assertive medical treatment for physical conditions, more patients are likely to present to psychiatric services suffering from adverse neuropsychiatric effects associated with corticosteroid use. A review of the effects of corticosteroids among older people was carried out through Medline and PubMed searches and a review of article references. Very little has been specifically written about steroid use and the effects on older people. This paper briefly outlines the current level of knowledge of neuropsychiatric effects of steroids, and relates this to general treatment considerations for older subjects. Recommendations for further research and early identification of complications are made.

Keywords

NeuropsychiatricCorticosteroidsElderly
Type
Review
Information
Irish Journal of Psychological Medicine , Volume 22 , Issue 1 , March 2005 , pp. 22 - 25
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Rome, HP, Braceland, FJ. The psychological response to ACTH, cortisone, hydrocortisone, and related steroid substances. Am J Psychiatry 1952; 108: 641–51.CrossRefGoogle ScholarPubMed
2.Brown, ES, Suppes, T. Mood symptoms during corticosteroid therapy; a review. Harvard Rev Psychiatry 1998; 5: 239–46.CrossRefGoogle ScholarPubMed
3.Ismail, K, Wessely, S. Psychiatric complications of corticosteroid therapy. Br J Hosp Med 1995; 53: 495–99.Google ScholarPubMed
4.Wolkowitz, OM, Rubinow, D, Doran, ARet al.Prednisone effects on neurochemistry and behaviour: preliminary findings. Arch Gen Psychiat 1990; 47: 963–8.CrossRefGoogle ScholarPubMed
5.Wood, KA, Harris, MJ, Morreale, A, Rizos, AL. Drug-induced psychosis and depression in the elderly. Psych Clin North America 1988; 11: 167–93.CrossRefGoogle ScholarPubMed
6.American Psychiatric Association. Diagnostic and statistical manual of psychiatric disorders 4th ed. Washington: American Psychiatric Association, 1994.Google Scholar
7.World Health Organisation. The ICD-10. Classification of Mental and Behavioural Disorders. WHO: Geneva, 1992.Google Scholar
8.Clark, LD, Bauer, W, Cobb, S. Preliminary observations on mental disturbances occurring in patients under therapy with cortisone and ACTH. N Engl J Med, 1952; 246: 205–16.CrossRefGoogle ScholarPubMed
9.Hall, RC, Popkin, MK, Stickney, SK, Gardner, ER. Presentation of the steroid psychoses. J Nerv Ment Dis 1979; 167: 229–36.CrossRefGoogle ScholarPubMed
10.Harris, JC, Caret, CA, Rosenberg, LAet al.Intermittent high dose corticosteroid treatment in childhood cancer: behavioural and emotional consequences. J Am Acad Child Adolesc Psychiatry 1986; 1: 120–4.CrossRefGoogle Scholar
11.Naber, D, Sand, P, Heigl, B. Psychopathological and neuropsychological effects of eight days corticosteroid treatment: a prospective study. Psychoneuroendocrinology 1996; 21: 25–31.CrossRefGoogle Scholar
12.Gift, AG, Wood, RM, Cahill, CA. Depression, somatisation and steroid use in chronic obstructive pulmonary disease. Int J Nurs Stud 1989; 26: 281–6.CrossRefGoogle ScholarPubMed
13.Reckart, MD, Eisendrath, SJ. Exogenous corticosteroid effects on mood and cognition: case presentation. Int J Psychosom 1990; 37: 57–61.Google Scholar
14.Lewis, DA, Smith, RE. Steroid induced psychiatric syndromes: a report of 14 cases and a review of the literature. J Affect Disord 1993; 5: 319–32.CrossRefGoogle Scholar
15.Wolkowitz, OM, Reus, VI, Weingartner, H, Thompson, Ket al.Cognitive effects of corticosteroids. Am J Psychiat 1990; 147: 1297–1303.Google ScholarPubMed
16.Varney, NR, Alexander, B, Maclndoe, JH. Reversible steroid dementia in patients without steroid psychosis. Am J Psychiatry 1984; 141: 369–72.Google ScholarPubMed
17.Sirois, F. Steroid psychosis: a review. Gen Hosp Psychiat 2003; 25: 27–33.CrossRefGoogle ScholarPubMed
18.Patten, SB, Neutel, CI. Corticosteroid-induced adverse psychiatric effects. Incidence, diagnosis and management. Drug Safety 2000; 22: 111–22.CrossRefGoogle ScholarPubMed
19.Ling, MHM, Perry, PJ, Tsuang, MT. Side-effects of corticosteroid therapy: psychiatric aspects. Arch Gen Psychiatry 1981; 38: 471–7.CrossRefGoogle ScholarPubMed
20.Goggans, FC, Weisberg, U, Koran, LM. Lithium prophylaxis of prednisone psychosis: a case report. J Clin Psychiat 1983; 44:111–2.Google ScholarPubMed
21.The Boston Collaborative Drug Surveillance Program. Acute adverse reactions to prednisone in relation to dosage. Clin Pharmacol Ther 1972; 13: 694–8.CrossRefGoogle Scholar
22.Sergent, JS, Lockshin, MD, Klempner, MS, Lipsky, BA. Central nervous system disease in systemic lupus erythematosus – therapy and prognosis. Am J Med 1975; 58: 644–54.CrossRefGoogle ScholarPubMed
23.Greeves, JA. Rapid-onset steroid psychosis with very low dosage of prednisolone (letter). Lancet 1984; 1:1119–20.CrossRefGoogle Scholar
24.Turktas, I, Gucuneyer, K, Ozden, A. Medication-induced psychotic reaction (letter). J Am Acad Child Adolesc Psychiat 1997; 36: 1017–8.CrossRefGoogle Scholar
25.Finkenbine, R, Gill, HS. Case of mania due to prednisone-clarithromycin interaction. Can J Psychiatry 1997; 42: 778.CrossRefGoogle ScholarPubMed
26.Broadbend, J, Jacoby, R. Mania in old age: a first prospective study. Int J Geriatric Medicine Psychiat 1990; 5: 215.Google Scholar
27.Young, RC, Klerman, GL. Mania in late life: focus on age of onset. Am J Psychiatry 1992; 149: 867–76.Google Scholar
28.Frey, BM, Frey, FJ. Clinical pharmacokinetics of prednisone and prednisolone. Clin Pharmacokinet 1990; 19: 126–46.CrossRefGoogle ScholarPubMed
29.Falk, WE, Mahnke, MW, Poskanzer, DC. Lithium prophylaxis of corticotrophin-induced psychosis. JAMA 1979: 241: 1011–2.CrossRefGoogle Scholar
30.Abbas, A, Styra, R. Valproate prophylaxis against steroid-induced psychosis (letter). Can J Psychiatry 1994; 39: 188–9.CrossRefGoogle Scholar
31.Lynn, DJ. Lithium in steroid-induced depression (letter). Br J Psychiat 1994; 166: 264.CrossRefGoogle Scholar
32.Brown, AS, Khan, D, Suppes, T. Treatment of corticosteroid-induced mood changes with olanzapine (letter). Am J Psychiat 1999; 156: 968.CrossRefGoogle Scholar
33.Terao, T, Yoshimura, R, Shiratuchi, Tet al.Effects of lithium on steroid-induced depression. Biol Psychiat 1997; 41: 1225–6.Google Scholar
34.Wyszynski, AA, Wyszynski, B. Treatment of depression with fluoxetine in corticosteroid dependent central nervous system Sjogren's syndrome. Psychosomatics 1993: 34: 173–7.CrossRefGoogle ScholarPubMed
35.Blazer, DG, Petrie, WM, Wilson, WP. Affective psychosis following renal transplant. Dis Nerv Syst 1976; 37; 663–7.Google Scholar
36.Ahmad, M, Rasul, FM. Steroid-induced psychosis treated with haloperidol in a patient with active chronic obstructive pulmonary disease. Am J Emerg Med 1999; 17: 735.CrossRefGoogle Scholar
37.Steifel, FC, Breibart, S, Holland, JC. Corticosteroids in cancer: neuropsychiatric complications. Cancer Invest 1989; 7: 479–91.CrossRefGoogle Scholar
38.DeSilva, C, Nurse, MC, Vokey, KSteroid-induced psychosis treated with risperidone. Can J Psychiatry 2002; 47: 388–9.CrossRefGoogle ScholarPubMed