From Mood Swings to Psychosis: Exploring the Psychiatric Side Effects of Corticosteroids

Introduction Corticosteroids are integral in treating various medical conditions across multiple specialties. However, they are known to induce psychiatric adverse effects, ranging from subtle mood changes and memory deficits to psychosis. Objectives This review aims to explore the current literature on these effects, identifying risk factors and strategies for early intervention. Methods A non-systematized literature review was carried out on PubMed and Google Scholar. The following words were searched: (“corticosteroids” OR “steroids” OR “glucocorticoids”) AND (“psychiatry symptoms” OR “psychosis” OR “mood” OR “memory”). Results Despite being recognized for their strong anti-inflammatory and immune-suppressing effects across various medical conditions, corticosteroid therapies frequently come with neuropsychiatric complications, the understanding of which is still limited. Although symptoms usually emerge within 3 to 4 days after starting corticosteroid treatment, they can manifest at any point, even after the therapy has been completed or stopped. Dosage is a significant risk factor, with high doses increasing the likelihood of psychosis. Depression is more prevalent among women. Additional risk factors include past psychiatric history, compromised blood-brain barrier, and hypoalbuminemia. However, some instances show beneficial outcomes, such as alleviation of depressive symptoms without triggering mania and improvements in cognitive function. Conclusions Early diagnosis and awareness are crucial in managing corticosteroid-induced psychiatric symptoms. Initial steps should involve tapering or discontinuing corticosteroids, supplemented by psychotropic medications if necessary. Disclosure of Interest None Declared