Objective: Since their introduction as therapeutic agents, corticosteroids have been associated with psychiatric symptoms ranging from mood disturbances to (florid) psychosis. By the time there have been reported psychotic reactions in patients receiving steroids or after sudden withdrawal of long time corticosteroid therapy. We communicate a clinical case in which the exogenous short-treatment with corticosteroids produced an hypothalamic-pituitary-adrenal axis inhibition leads to a psychotic disorder two weeks later.
Method: Case presentation, clinical and research literature review, and theoretical discussion.
Results: There is consensus in the literature that corticosteroids may induce psychotic disorders, but the published evidence documenting so is scant, consisting only of case reports. We did not find any reported case provoked by depot steroids like the one we present.
Conclusions: The literature concerned with the prevention and management of corticosteroid-induced psychiatric adverse effects is rudimentary, and contains large amounts of clinical anecdotes. Due to the lack of formal and validated studies, these reports currently provide the only available direction to clinicians in managing these problems.