Psychiatric Side Effects of Steroid Therapy

Kershner, Pamela; Wang-Cheng, Rebekah

doi:10.1016/s0033-3182(89)72293-3

Cited by 96 publications

(46 citation statements)

References 36 publications

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“…Corticosteroids, which are used in high doses for short courses to treat acute exacerbations, have been associated with a variety of neuropsychiatric side effects, including increased energy, decreased sleep, and significant mood symptoms such as mood lability, euphoria, and depressed mood. [17][18] Epidemiologic studies suggest an incidence of neuropsychiatric side effects from corticosteroid treatment of 5-8%. [18][19] It is difficult to predict which patients are at highest risk for the emergence of neuropsychiatric symptoms during corticosteroid treatment.…”

Section: Psychiatric Effects Of Ms Treatmentmentioning

confidence: 99%

“…[17][18] Epidemiologic studies suggest an incidence of neuropsychiatric side effects from corticosteroid treatment of 5-8%. [18][19] It is difficult to predict which patients are at highest risk for the emergence of neuropsychiatric symptoms during corticosteroid treatment. There is no clear evidence that a previous psychiatric history increases the risk of adverse neuropsychiatric events from steroid treatment [20], and overall there is little data to help identify individuals who are at increased risk.…”

Section: Psychiatric Effects Of Ms Treatmentmentioning

confidence: 99%

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Psychiatric Issues in Multiple Sclerosis

Chwastiak

Ehde

2007

Psychiatric Clinics of North America

140

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Section: Psychiatric Effects Of Ms Treatmentmentioning

confidence: 99%

Section: Psychiatric Effects Of Ms Treatmentmentioning

confidence: 99%

Psychiatric Issues in Multiple Sclerosis

Chwastiak

Ehde

2007

Psychiatric Clinics of North America

140

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“…16 The unwanted side effects, however, such as myopathy, glucose intolerance, psychiatric disturbances and an increased susceptibility of infections mandate the judicious use of steroids. [17][18][19][20] Furthermore, treatment strategies vary widely in many transplant centers 10,11 and the benefit of high-dose steroids in critically ill DAH patients remains undefined. Adjunctive therapies such as the antifibrinolytic agent aminocaproic acid (ACA) have also been proposed, 15 and over 60% of ICU patients with DAH in our institution receive intravenous ACA despite the uncertain efficacy.…”

Section: Introductionmentioning

confidence: 99%

Low-, medium- and high-dose steroids with or without aminocaproic acid in adult hematopoietic SCT patients with diffuse alveolar hemorrhage

Rathi

Tanner

Dinh

et al. 2014

Bone Marrow Transplant

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Diffuse alveolar hemorrhage (DAH) is a poorly understood complication of transplantation carrying a high mortality. Patients commonly deteriorate and require intensive care unit (ICU) admission. Treatment with high-dose steroids and aminocaproic acid (ACA) has been suggested. The current study examined 119 critically ill adult hematopoietic transplant patients treated for DAH. Patients were subdivided into low-, medium-and high-dose steroid groups with or without ACA. All groups had similar baseline characteristics and severity of illness scores. Primary objectives were 30, 60, 100 day, ICU and hospital mortality. Overall mortality (n = 119) on day 100 was high at 85%. In the steroids and ACA cohort (n = 82), there were no significant differences in 30, 60, 100, day, ICU and hospital mortality between the dosing groups. In the steroids only cohort (n = 37), the low-dose steroid group had a lower ICU and hospital mortality (P = 0.02). Adjunctive treatment with ACA did not produce differences in outcomes. In the multivariate analysis, medium-and high-dose steroids were associated with a higher ICU mortality (P = 0.01) as compared with the low-dose group. Our data suggest that treatment strategies may need to be reanalyzed to avoid potentially unnecessary and potentially harmful therapies.

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“…Moreover, in particular patients, other tests should also be considered before i.v. MP treatment: -psychiatric consultation -in cases of history of psychiatric disorders [66,67] -dual X-ray absorptiometry (DXA) is recommended at baseline in all patients starting GCS treatment with doses ≥ 5 mg prednisone or its equivalent according to the Polish Recommendations for the Prevention and Treatment of Osteoporosis [68] or any dose according to ACR [69] with an anticipated duration of more than three months. It seems reasonable to consider this procedure also in patients treated with i.v.…”

Section: Szkolenie Podyplomowementioning

confidence: 99%

“…Ponadto, u poszczególnych chorych należy również rozważyć: -przeprowadzenie konsultacji psychiatrycznej -u chorych z wywiadem zaburzeń psychiatrycznych [66,67];…”

Section: Układ Sercowo-naczyniowyunclassified

Czy stosowanie dużych dawek metyloprednizolonu w dożylnych pulsach u chorych z orbitopatią Gravesa jest bezpieczne?

Miśkiewicz

Kryczka

Ambroziak

et al. 2014

Endokrynologia Polska

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High dose intravenous glucocorticoid pulse (i.v. GCS) therapy is a proven approach in patients with active, moderate to severe Graves' orbitopathy (GO) and dysthyroid optic neuropathy (DON). In moderate to severe GO, the European Group on Graves' Orbitopathy (EUGOGO) recommends a 12-week course of intravenous methylprednisolone (i.v. MP) pulse therapy with a cumulative dose of 4.5 g. The response rate of i.v. GCS treatment is significantly higher than oral glucocorticoid (oral GCS) therapy and is associated with fewer adverse events. However, a major concern was raised because of reports of fatal side effects which may be associated with this therapy, especially when single and cumulative doses of methylprednisolone (MP) are higher than recommended. The prevalence and severity of adverse effects during treatment have not been fully described. The aim of this review was to summarise the frequency of major adverse effects of i.v. GCS compared to oral GCS and attempt to propose some practical suggestions as to how to monitor and prevent the development of side effects.

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Psychiatric Side Effects of Steroid Therapy

Cited by 96 publications

References 36 publications

Psychiatric Issues in Multiple Sclerosis

Psychiatric Issues in Multiple Sclerosis

Low-, medium- and high-dose steroids with or without aminocaproic acid in adult hematopoietic SCT patients with diffuse alveolar hemorrhage

Czy stosowanie dużych dawek metyloprednizolonu w dożylnych pulsach u chorych z orbitopatią Gravesa jest bezpieczne?

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