Steroid-induced psychosis
Background
- In 718 hospitalized patients, 4.6% of patients on 40 mg or higher per day of prednisone had psychiatric symptoms[1]
- Incidence rises to 18.4% for patients receiving more than 80 mg per day
- Mechanism unproven but thought to be increased dopamine due to induction of tyrosin hydroxylase by corticosteroids[2]
Clinical Features
- Wide range of possible psychiatric symptoms
- Delusions or hallucinations
- Euphoria
- Mania, depression, anxiety
- Severe cases may present with suicidal ideation, violence, aggression
Differential Diagnosis
Evaluation
Workup
- Diagnosis of exclusion
Diagnosis
- Consider AMS workup