Researchers from Leiden University Medical Center have found that prescribed steroids cause structural and volume changes in the white and gray matter of the brain. Scientists believe these findings may help explain some of the psychiatric side effects of prescribed steroids, though more research is needed.
Corticosteroids reduce GABA, leading to anxiety, changes in mood, depression, seizure disorders, and a decreased capacity to cope with chronic pain. Corticosteroids may also impact the hippocampus in the brain, which regulates memory and emotional processing.
A wide range of psychiatric reactions have been reported in association with corticosteroids, including: affective disorders (eg, irritable, euphoric, depressed, and labile mood, and suicidal thoughts); psychotic reactions (eg, mania, delusions, hallucinations, and aggravation of schizophrenia); behavioural ...
Psychiatric side effects including mania, depression, psychosis, and delirium, are extremely common in patients treated with corticosteroids.
People taking steroids -- even inhaled steroids -- appear to have less intact white matter structure in their brains compared with those not taking the drugs, brain scans reveal. White matter serves as the communication link between different regions of the brain.
Anabolic steroids affect the brain neurotransmitter systems.
It has been studied that steroids affect the brain serotonin and dopamine neurotransmitter systems. Dopamine is a multi-function neurotransmitter participating in the regulation of mobility, learning, emotions, appetite and positive reinforcing effects.
Steroid use can cause anxiety, depression, paranoia and psychosis in those people who have a vulnerability to mental health problems. Drug use can lead to social and emotional problems and affect a person's relationship with family and friends.
"Additionally we have shown that long-term treatment of steroids can block its effectiveness at all times of day and could contribute to the brain fog experienced by many people on steroids."
Neuropsychiatric adverse effects during systemic corticosteroid therapy occur frequently. Cognitive deficits, particularly declarative and verbal memory deficits, have been documented during both long- and short-term glucocorticoid therapy.
Some people who take steroids say the drugs make them feel powerful and energetic. However, steroids are also known to increase irritability, anxiety and aggression and cause mood swings, manic symptoms and paranoia, particularly when taken in high doses.
Hypomania and mania are the most common mood changes during acute corticosteroid therapy, although depression has also been reported. However, depression is reported to be more common than mania during long-term treatment with corticosteroids.
Some examples include: Cartilage damage: Because there are repetitive injections into one area, the cartilage of the bone can become weak, causing it to break easier or become more inflamed than before. Joint infection: Similar to cartilage damage, the more injections into one area, the weaker the area can get.
Conclusions: Steroid-induced psychosis is a serious adverse effect of corticosteroid therapy; however, management strategies that combine a dose reduction or elimination of steroids, in combination with an antipsychotic medication, are effective in resolving this syndrome.
Within days of beginning the glucocorticoid treatment, however, the patient began to show symptoms that included major depression, irritability, muscle weakness, and hallucinations ("stars" or "spots").
This medicine may cause changes in mood or behavior for some patients. Tell your doctor right away if you have depression, mood swings, a false or unusual sense of well-being, trouble with sleeping, or personality changes while using this medicine.
Pain and Swelling (Cortisone Flare)
The injected cortisone medication can crystallize inside the body. The crystals can cause pain and inflammation that is worse than the pain and inflammation caused by the condition being treated. This side effect is called a cortisone flare.
Clinical Manifestation Early indicators of steroid-induced psychosis include confusion, perplexity, and agitation that typically occur within the first five days after initiation of treatment (6-7). Patients may go on to develop hallucinations, delusions, and cognitive impairment (2).
How long will it be detectable? If taken orally, steroids can show up in a urine test for up to 14 days. If injected, steroids can show up for up to 1 month.
This is usually minor and self limiting. The cortisone may result in palpitations, hot flushes, insomnia, and mild mood disturbance. This usually resolves within 24 hours and no treatment is necessary.
Oral and Inhaled Glucocorticoids Both Trigger Brain Decline
Common glucocorticoids include medications such as Flonase (fluticasone) and prednisone.
Lowering steroid levels too quickly can also cause a rebound increase in brain swelling and return of symptoms and sometimes joint pain. Steroids can cause a wide range of unwanted effects.
There is no medical limit on the number of injections a person can receive. However, there are concerns about repeated cortisone injections in specific areas of the body. Also, individual response to a cortisone shot varies. Some patients do not experience pain relief with cortisone treatments.
Cortisone is a steroid because it's a synthetic version of the hormone cortisol. Steroids are artificial hormones produced by the adrenal glands.
Most often, oral corticosteroids are prescribed for roughly 1 to 2 weeks — and only for very severe symptoms. But for certain chronic health conditions, corticosteroids may be necessary for months or even years. The longer you take steroids, the more likely it's that you'll have side effects.