Acute onset of steroid psychosis with very low dose of prednisolone in Sheehan's syndrome

Endocr J. 2006 Apr;53(2):255-8. doi: 10.1507/endocrj.53.255.

Abstract

Corticosteroid treatment is frequently associated with psychiatric disturbances. These adverse effects are unusual with low dose of corticosteroid. We describe a patient who rapidly developed a steroid-induced psychosis with very low dose of prednisolone. A 48-year-old woman of Sheehan's syndrome was admitted to hospital with insomnia, euphoric moods and visual hallucinations. She had taken prednisolone (10 mg in the morning and 5 mg at night) for 6 days before admission. These symptoms appeared after first dose of prednisolone. A diagnosis of acute psychosis was made. After improvement of acute psychosis with discontinuation, re-administration of prednisolone at a dose of 2.5 mg per day gave rise to agitation and insomnia. She recovered completely by gradual dosage increase of short-acting corticosteroid after the discontinuation of prednisolone.

Publication types

  • Case Reports

MeSH terms

  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Hypopituitarism / complications*
  • Hypopituitarism / drug therapy*
  • Middle Aged
  • Prednisolone / administration & dosage*
  • Prednisolone / adverse effects*
  • Psychoses, Substance-Induced / etiology*
  • Thyroxine / administration & dosage

Substances

  • Prednisolone
  • Thyroxine