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Aug 14, 2019

WCP-2019

WHEN THE DISEASE ARISES FROM THE TREATMENT: CORTICOSTEROID-INDUCED PSYCHOSIS A CASE REPORT AND BRIEF LITERATURE REVIEW

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corticosteroid-induced psychosis

corticosteroids

psychiatric adverse effects of corticosteroids

Abstract

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Abstract

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Keywords

corticosteroid-induced psychosis

corticosteroids

psychiatric adverse effects of corticosteroids

Abstract

Objectives: This study proposes to clarify the development of corticosteroid-induced psychosis focusing on risk factors, the onset timing of symptoms and therapeutic strategy. Background and aims: Corticosteroids are a potent therapeutic option in medicine in general, especially in high-dose treatments (higher than 40 mg/day of prednisone or equivalent), which is associated with a 20% risk of developing severe psychiatric symptomatology that justifies the use of psychotropics similar to those used in the same idiopathic psychopathologies. Materials and methods: Systematic review on neuropsychiatric effects of corticosteroid treatment using as a database: Medline and PubMed, illustrated by a case report with information from a clinical interview. Results: We report the case of a 51-year-old female patient, recently diagnosed with breast cancer, who underwent mastectomy and axillary lymph node clearance and was under adjuvant chemotherapy (submitted to a high dose of corticosteroids as integral part of the scheme. The patient checked into the emergency room with behavioral alterations, delusions of mystical and paranoid content, and auditory hallucinations. Given the absence of psychiatric antecedents, and after exclusion of organic cause, delusional alterations were interpreted as a direct result of corticotherapy, a known cause of the symptomatology described abo. Clinical improvement was observed with the establishment of antipsychotic therapy. Conclusion: Due to the significant risk of corticosteroid-induced psychosis and the absence of applicable guidelines, it is important to address this issue, alerting health professionals to the possible therapeutic strategies, with antipsychotics and mood stabilizers, outcome and expected evolution of the symptoms.

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© Copyright 2019 Morressier GmbH.
All rights reserved.