Adverse Psychiatric Reactions Information Link
Promoting awareness of medicines that can harm mental health

ADR experiences Corticosteroids

CASE STUDIES  ADRs Corticosteroids

Steroid Psychosis

Suicide of photographer Donovan

Dr Thomas Stuttaford wrote about steroid psychosis in The Times 25th November 1996 following the suicide, while on corticosteroids for asthma, of the famous photographer, Donovan. Short courses of high dose oral steroids can induce a wide range of psychiatric problems. changes in mood, either unreasonable elation or depression to the extent of producing feelings of hopelessness and suicidal thoughts, are the most common undesirable effects."

Suicide of nurse's father

APRIL has been contacted by a nurse following her father's suicide after suddenly stopping a dose of 40 mg a day for only two weeks of prednisolone.  He had received no advice about slow reduction in spite of also being on inhaled steroids. The adrenal system may have been already compromised from the inhaled drug.

Hospital apology following poor advice a lack of duty of care

We were told by a lady who suffered steroid withdrawal psychosis, that she received an apology from the hospital after discharging her with abrupt cessation of corticosteroids. The hospital promised to re- train staff in light of her experience

Steroid Dementia

Psychtoropic effect of corticosteroids - reversible steroid dementia mimics Alzheimer's disease:


Psychotropic effects of corticosteroids have been reported since early 1950. Dementia-like cognitive changes in patients undergoing treatment with high doses of corticosteroids were identified in 1984. The clinical presentation of these steroid dementia patients, mimicked those typical of early Alzheimer's disease. As with psychiatric side effects of croticosteroid use, the dementia is reversible. The case presented describes a patient who developed dementia-like cognitive changes and an abnormal EEG as a result of steroid treatment. The case is of interest not only as an example of steroid dementia, but also because it is the first with documented electroencephalographic sequelae and premorbid EEG, CT scan and neuropsychological testing.

Reversible steroid dementia in patients without steroid psychosis

American Journal of Psychiatry

Am J Psychiatry 1984; 141:369-372 - NR Varney, B Alexander and JH MacIndoe

Six patients developed dementia-like cognitive changes that appeared to result from administration of steroid medications. Four of the patients never showed symptoms of steroid psychosis; the remaining two continued to show steroid dementia well after their steroid psychoses had resolved. The dementia was characterized by deficits in memory retention, attention, concentration, mental speed and efficiency, and occupational performance. All six patients eventually recovered normal mental status following discontinuation or reduction of steroid medications. Larger prospective studies are needed to determine the prevalence and nature of the syndrome


Considered opinion

Please note that from personal family experience of the founder of APRIL and the information received from the public, we believe excessive use of psychotropic medicines, in cases of psychiatric adverse drug reactions (ADRs) may be unnecessary. There is little or no scientific evidence to back up the need for anything other than vigilance and careful monitoring with just enough medication to calm the situation day by day, while the cortico-steroids are gradually reduced if this is possible. A sensible psychiatrist will assess the situation and hopefully understand this is not a new long term menatally ill patient but a temporary effects of a psychiatric adverse drug reaction (ADR)

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