Lifelong Learning: Adverse Consequences of Glucocorticoid Medication: Psychological, Cognitive, and Behavioral Effects-View Article

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Glucocorticoids, commonly prescribed anti-inflammatory/immunosuppressant medications, can have significant psychological, cognitive, and behavioral effects. Severe neuropsychiatric consequences have been reported, including suicide, suicide attempts, psychosis, mania, depression, panic disorder, and delirium. However, the majority of patients experience less severe but distressing changes in mood, cognition, memory, or behavior during glucocorticoid treatment or withdrawal. The risk of these effects can vary with age, gender, dosage, prior psychiatric history, and other biological markers. The mechanisms thought to underlie these risk factors are still being studied. Recommendations are provided for identifying individual risk factors and for monitoring and managing adverse neuropsychiatric effects of glucocorticoids. It is important to note that glucocorticoids are still a valuable and sometimes life-saving treatment for many medical conditions. However, their use should be carefully considered, and the risks and benefits should be weighed before prescribing. Patients should be educated about possible side effects and should be closely monitored for changes in mood, memory, thinking, or behavior. Dosage reduction or discontinuation is the first-line treatment for severe neuropsychiatric effects, and specific medications may be used to address specific symptoms, such as lithium for mania and selective serotonin reuptake inhibitors for depressive symptoms. Prophylactic treatment may also be considered for patients at greater risk for neuropsychiatric effects.

Keywords

Glucocorticoids

neuropsychiatric effects

psychological effects

cognitive effects

behavioral effects

mood changes

memory changes

dosage

adverse effects

monitoring