Steroid-induced psychosis Background ~5% of patients on ≥40 mg daily of prednisone have psychiatric symptoms [1] Incidence rises to just under 20% for patients receiving more ≥80 mg per day Mechanism unproven but thought to be increased dopamine due to induction of tyrosin hydroxylase by corticosteroids [2] Clinical Features Time of onset. The emergence of manic and psychotic symptoms after steroid withdrawal can thus also occur. Fourth, age is an additional risk factor, with elderly patients who seem to be more susceptible to experiencing corticosteroid-induced symptoms of mania and/or psychosis ( Psychiatric adverse effects during systemic corticosteroid therapy are common. Two large meta-analyses found that severe reactions occurred in nearly 6% of patients, and mild to moderate reactions occurred in about 28%. Although disturbances of mood, cognition, sleep, and behavior as well as frank delirium or even psychosis are possible, the most common adverse effects of short-term. Steroid psychosis is a condition characterized by psychiatric symptoms that emerge after using certain medications called corticosteroids. This uncommon side effect can cause symptoms ranging from subtle mood shifts to more pronounced psychotic features. Corticosteroids are extensively used in medicine for their powerful anti-inflammatory and immunosuppressive effects. However, their psychiatric side effects—such as mood disturbances, anxiety, and psychosis—are significant yet often underappreciated. This review provides a comprehensive exploration of corticosteroid-induced psychiatric disorders, with a focus on their underlying mechanisms. Steroid-induced psychosis is a rare but serious side effect of corticosteroid use, affecting approximately 5-18% of patients receiving high-dose steroid therapy. While corticosteroids are essential for treating inflammatory, autoimmune, and allergic conditions, they can also disrupt brain chemistry, leading to psychiatric symptoms, including mood swings, anxiety, paranoia, and hallucinations. Steroid-induced psychosis (SIP) is a severe psychiatric reaction that develops as an adverse effect of taking corticosteroid medications. This condition is defined by the acute onset of psychotic symptoms, such as a detachment from reality, that emerge after starting the drug. While corticosteroids are widely used for their anti-inflammatory power, this complication is rare, affecting an. Steroid-induced psychosis is a known adverse effect of treatment with corticosteroids. On average, the time of onset is several days after exposure to the steroid. A 91-year-old man presented with left buttock pain with radicular features and was. Steroid-induced psychosis is a severe psychiatric adverse effect that can result from treatment with high-dose glucocorticoids. Management If patients are found to have severe symptoms of mania or psychosis, the dose of the corticosteroid should first be tapered to 40 mg/day of prednisone (dexamethasone dose equivalent of 6 mg po), or the lowest dose possible (10,13,14).