Takasato Y, Arai T, Ohta Y
Department of Neurosurgery, Tachikawa National Hospital, Japan.
No To Shinkei. 1992 Oct;44(10):913-6.
Psychotic side effects of steroids have been observed at relatively high frequency if mild cases, such as euphoria, are included, while it has been said that incidences differ among kinds of steroids. We reported a case developing severe schizophrenia-like symptoms following the treatment with betamethasone although this drug is believed to be rarely involved in steroid-induced psychosis, and its psychotic side effects have been rarely reported. When betamethasone was administered for progressive peripheral facial paralysis at a mean daily dose of 7mg, psychotic symptoms appeared from the 15th treatment day. Psychosis began with interrupted appearance of excitation, autism, and misanthropia. Although the steroid was gradually decreased in dose because of abatement of facial paralysis, not only psychotic symptoms were aggravated, but also appeared hallucination. Thus the steroid was withdrawn before the scheduled date while its dose was gradually decreased, and haloperidol was administered. Psychotic symptoms were gradually eliminated and completely disappeared about 40 days after onset.
如果将欣快等轻度病例包括在内，类固醇的精神病性副作用在相对较高的频率下被观察到，而据说不同种类的类固醇发生率有所不同。我们报告了一例在使用倍他米松治疗后出现严重精神分裂症样症状的病例，尽管人们认为这种药物很少引发类固醇所致精神病，且其精神病性副作用也鲜有报道。当以平均每日7毫克的剂量给予倍他米松治疗进行性周围性面瘫时，从第15个治疗日开始出现精神病性症状。精神病始于兴奋、孤独症和厌世情绪的间歇性出现。尽管由于面瘫减轻类固醇剂量逐渐减少，但不仅精神病性症状加重，还出现了幻觉。因此，在按计划日期之前，在类固醇剂量逐渐减少的同时将其停用，并给予了氟哌啶醇。精神病性症状逐渐消除，发病约40天后完全消失。
