DOI: 10.36347/sjmcr.2024.v12i05.093

Pages: 931-933

Corticosteroids are widely used to treat various medical conditions, but can cause significant psychiatric side effects including anxiety, mood disorders, psychosis, and suicidal behavior. We present a case of a 23-year-old woman who developed manic symptoms after receiving corticosteroids for acute disseminated encephalomyelitis (ADEM). The patient exhibited agitation, logorrhea, insomnia, disinhibition and a suicide attempt shortly after corticosteroid dose reduction. Discontinuation of antidepressants and tapering of corticosteroids, along with antipsychotic treatment with olanzapine, led to symptom improvement. Corticosteroid-induced psychiatric disorders occur in 1.5-57% of patients, with higher doses conferring greater risk. Other risk factors include female sex, history of psychiatric disorders, and underlying neurological conditions that compromise the blood-brain barrier. Gradual corticosteroid taper and addition of psychotropic medications may be required to manage severe cases. This case highlights the importance of monitoring for psychiatric side effects in patients receiving corticosteroids, and the need for therapeutic education to recognize and manage these potentially serious complication.