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

Published online by Cambridge University Press:  26 August 2025

A. Pedro Costa*
Affiliation:
Departamento de Saúde Mental, Unidade de Saúde do Baixo Alentejo, Beja
M. Mousinho
Affiliation:
Departamento de Saúde Mental, Unidade de Saúde do Baixo Alentejo, Beja
A. Matos Pires
Affiliation:
Departamento de Saúde Mental, Unidade de Saúde do Baixo Alentejo, Beja
G. Simões
Affiliation:
Departamento de Psiquiatria e Saúde Mental, Unidade Local de Saúde da Região de Aveiro, Aveiro
A. I. Gomes
Affiliation:
Departamento de Psiquiatria e Saúde Mental, Unidade Local de Saúde da Região de Aveiro, Aveiro
A. R. Coelho
Affiliation:
Serviço de Oncologia Médica, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
*
*Corresponding author.

Abstract

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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

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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