Three cases of steroid psychosis

Abstract

It has been well known that the mental disturbance is one of the major side effects of adrenocortical steroid drugs. Emotional changes such as euphoria and/or depression were frequently observed in some patients treated with steriods. Recently, however, a variety of mental disorders other than emotional disturbances has been reported. In this paper, three cases of steroid induced psychosis are reported. Case 1: The patient was a 70-year-old male with pulmonary silicosis treated with dexamethasone (2∼3 mg/day) who became a hypomanic state. Dexamethasone was switched to betamethasone in addition to administration of diazepam and thioridazine. One month later, the psychotic symptomes disappeared. Case 2: The patient was a 32-year-old female with SLE treated with dexamethasone (0.5∼2.5 mg/day) who was presented in an acute hallucinatory state. Dexamethasone was exchanged for prednisolone, and levomepromazine was added. In 10 days, the symptoms cleared rapidly. Case 3: The patient was a 54-year-old male with bronchial asthma treated with the combination of hydrocortisone (500 mg inj/day) and prednisolone (10∼40 mg/day) who developed an auditory hallucination. The steroid was tapered and then discontinued while, haloperidol was prescribed. In 7 days, the symptoms cleared rapidly. All cases had neither antecedent episodes of psychosis nor psychotic patients in the families. © 1989, Japanese Society of National Medical Services. All rights reserved.