Corticosteroids, immune suppression, and psychosis

Perantie, Dana C.; Brown, E. Sherwood

doi:10.1007/s11920-002-0023-8

Cited by 35 publications

(12 citation statements)

References 52 publications

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“…In the above case, our patient suffered from a severe chronic disease, the bereavement of his wife, and a possibly untreated reactive depression, which may be seen as being responsible for unexpressed and unconscious suicidal behavior. In addition to the immunodeficiency, the continued corticosteroid administration probably exacerbated or increased the concurrent mood disturbances, as shown in the relevant literature, 24 and probably steered the patient toward self-medication without any resort to medical controls.…”

Section: Discussionmentioning

confidence: 95%

Fatal Long-term Immunosuppressive Therapy With Uncontrolled Repeat Prescription

Manfredi¹,

Sabbatani²,

Orcioni

et al. 2006

Therapeutic Drug Monitoring

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A case of nephrotic syndrome treated with associated cyclophosphamide and corticosteroids came to our attention after over 2 years of self-administered immunosuppressive therapy which remained unchanged and uncontrolled during this period. The self-administered therapy resulted in a severe cell-mediated immunodeficiency (as expressed by a nadir CD4 lymphocyte count of 2 cells/muL). This led to a rapid unfavorable progression of hepatitis B, which was recently acquired and subsequently evolved into a severe cholestatic and fibrosing chronic hepatitis, causing multiple end-organ failure, and ultimately, death. This process was not reversed by lamivudine therapy, hemodialysis, and the use of a Molecular Adsorbent Recirculating System. The role played by repeated drug prescriptions from general practitioners without appropriate clinical and laboratory controls, and that of our patient's depression are discussed. Current literature related to the presented case and the ongoing debate regarding repeated prescriptions are considered in this study.

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Section: Discussionmentioning

confidence: 95%

Fatal Long-term Immunosuppressive Therapy With Uncontrolled Repeat Prescription

Manfredi¹,

Sabbatani²,

Orcioni

et al. 2006

Therapeutic Drug Monitoring

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“…Regarding the treatment of rashes with corticosteroids, they can aggravate the depressive or mixed state of bipolar disorder, thus making it advisable to avoid them as much as possible. 26…”

Section: Figurementioning

confidence: 99%

Retratamiento con lamotrigina después de reacción cutánea de rash. Estudio de casos abiertos y metaanálisis combinados

Serrani¹

2013

Revista de Psiquiatría y Salud Mental

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Rechallenge is a viable option after a benign lamotrigine-induced rash, and can even be rechallenged after rash with greater precautions when there exists one or two potentially serious signs. In cases of more serious rash there are no reliable data available on rechallenge safety and it may pose a significant risk. In those cases rechallenge should better be avoided between 4 weeks from first rash.

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“…antituberculosis drugs, dapsone and sulphadiazines. 4,16 These 'psychotoxic' reactions, which may manifest as psychosis, mania or delirium, have been associated with the commencement of treatment with isoniazid, ethionamide, ethambutol and some of the fluoroquinolones. A study in Peru found that severe psychiatric syndromes associated with isoniazid occurred in approximately 1% of patients with tuberculosis between 1991 and 1999.…”

Section: Psychosis As a Complication Of Medical Treatmentmentioning

confidence: 99%