Bachu Anil K, Davis Victoria, Abdulrahim Mouad, Harbaugh Lauren, Prasad Sakshi, Kotapati Vijaya Padma, Srinivas Sushma
Psychiatry and Behavioral Sciences, Baptist Health - University of Arkansas for Medical Sciences (UAMS), Little Rock, USA.
Psychiatry and Behavioral Sciences, Allegheny Health Network, Pittsburgh, USA.
Cureus. 2023 May 19;15(5):e39221. doi: 10.7759/cureus.39221. eCollection 2023 May.
Corticosteroids are commonly used for pain management and inflammatory conditions but can cause neuropsychiatric complications ranging from anxiety to severe mood and psychotic symptoms. These complications can occur shortly after steroid treatment begins or at any point during therapy, and even after treatment has stopped. We present three cases of corticosteroid-induced psychosis in patients being treated for pain. The mechanism behind these complications is not fully understood, but stress on the hypothalamic-pituitary-adrenal (HPA) axis is thought to play a role. Clinicians should be cautious and regularly evaluate patients to minimize the risk of complications. More research is needed to understand the underlying pathophysiology.
皮质类固醇常用于疼痛管理和炎症性疾病,但可引发从焦虑到严重情绪及精神症状等一系列神经精神并发症。这些并发症可在类固醇治疗开始后不久出现,或在治疗期间的任何时间发生,甚至在治疗停止后也会出现。我们报告了3例在接受疼痛治疗的患者中发生的皮质类固醇所致精神病病例。这些并发症背后的机制尚未完全明确,但下丘脑-垂体-肾上腺(HPA)轴的应激被认为起了一定作用。临床医生应谨慎行事,并定期对患者进行评估,以将并发症风险降至最低。需要更多研究来了解潜在的病理生理学。