Advise Patients to Report Psychiatric Effects With Steroids

    Many patients don't realize that corticosteroids can cause psychiatric effects...especially in high doses.

   Changing endogenous cortisol levels can lead to anxiety, insomnia, mania, psychosis, delirium, depression, and other psychiatric effects.

   These effects occur in about 1% of patients on oral prednisone ≤ 40 mg/day...compared to 5% on 41 to 80 mg/day and 18% on > 80 mg/day.

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