Unbound MEDLINE

Corticosteroid induced psychosis in the pain management setting.

Abstract

BACKGROUND
Synthetic corticosteroids are commonly utilized in interventional pain management procedures. These substances have potential side-effects including psychological adverse events.
OBJECTIVE
We describe a case of substance-induced psychotic disorder resulting from corticosteroids administration.
DESIGN
Case Report.
METHODS
We describe a 67-year-old male that, six months prior to being consulted at our center, received a cervical epidural, 4 level medial branch blocks, 4 trigger point injections and a tendon injection in the shoulder all including corticosteroids all in one treatment session.
RESULTS
Approximately 7 days following the multiple injections, the patient developed psychotic episodes including racing thoughts, anger, agitation, pressured hyperverbal speech and paranoia. The symptoms spontaneously resolved in approximately 7-10 days.
DISCUSSION
Although well known as a potential complication, corticosteroid induced psychosis secondary to interventional pain procedures have never been reported. We further discuss this potential side effect of utilizing corticosteroids and emphasize the need for guidelines regarding steroid utilization.

Links

  • FREE Publisher Full Text
  • Authors

    Benyamin RM, Vallejo R, Kramer J, Rafeyan R

    Source

    Pain physician 11:6 pg 917-20

    MeSH

    Adrenal Cortex Hormones
    Aged
    Aggression
    Anger
    Anti-Inflammatory Agents
    Cervical Vertebrae
    Domestic Violence
    Drug Administration Schedule
    Humans
    Injections, Epidural
    Male
    Methylprednisolone
    Myofascial Pain Syndromes
    Neck Pain
    Nerve Block
    Paranoid Personality Disorder
    Psychoses, Substance-Induced
    Time Factors
    Triamcinolone

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    19057637