Hipomanía y corticoides en pacientes oncológicos. Reporte de un caso y revisión de la literatura

Abstract

Introduction: Every year the number of people affecting by cancer increase. Corticosteroids are widely used in the treatment of patients with cancer and their use is not without adverse effects, often very disabling. Objective: Present a clinical case of hypomanic outbreak in a patient with ovarian cancer using corticosteroids and to carry out a review of the literature on the subject. Clinical case: Patient with an advanced ovarian cancer, treated with surgery and chemotherapy, debuts with episodes of vomiting that are managed with dexamethasone. During the treatment he presented insomnia, verbiage and grandiosity, diagnosing a hypomanic outbreak secondary to steroidal treatment. Discussion: In cancer patients, and independently of the use of corticosteroids, approximately 50% of them will present some type psychiatric disorder. With corticosteroids the incidence can increase up to 65%-75%. Hypomania accounts for almost 50% of psychiatric disorders induced by corticosteroids. With doses lower than 40 mg/day only 2% of patients will be affected by this type of disorders, while with doses between 40 to 80 mg/day this incidence increases up to 5%. Conclusion: Corticosteroids are widely used in cancer patients, however their use can cause psychiatric disorders. It is important to make the healthcare team more aware of the association of corticosteroids and psychiatric symptoms for rapid detection and clinical management.