Dr. Weeks’ Comment: Another biochemical consequence of sleep deprivation, as the wise Dr. Saul Pilar reminded me, is stress-induced elevation of glucocorticoids which can also cause psychosis. Elderly men, in particular, dealing perhaps with prostate infections or other infections like pneumonia or most recently COVID, can often become psychotic based upon this stress induced steroid surge. Understanding the biochemistry of stress induced psychosis, be it glucocorticoid excess or excess adrenalin from sleep deprivation or infections, is essential for destigmatizing these nervous breakdown experiences. Rather than deserving a diagnosis of mental illness, this is a breakdown which, practically speaking, is correctable and often simply amounts to a learning experience on how to take better care of oneself.
~~
doi: 10.1016/j.jaclp.2023.01.001. Epub 2023 Jan 9.
New-Onset Psychosis in the Context of COVID-19 Infection: An Illustrative Case and Literature Review
- PMCID: PMC9827676
- DOI: 10.1016/j.jaclp.2023.01.001
Abstract
Background: Infection with COVID-19 virus can result in a wide array of neuropsychiatric symptoms, such as anxiety, depression, psychosis, and delirium. Complications can occur even in the absence of a severe respiratory illness.
Conclusions: This review shows the necessity of additional research on psychosis due to COVID-19 in order to better understand the course of illnesses and the most effective treatment.
AND
Psychosomatics . 2018 Jul-Aug;59(4):394-399.
doi: 10.1016/j.psym.2017.06.003. Epub 2017 Jun 9.
Psychosis Due to Disseminated Cryptococcal Infection and Delirium in an Immunocompetent Patient: A Case Report and Review of the Literature
Jungjin Kim 1, Georgina Hartzell 2,
Neurologic & Psychiatric Effects of stress induced high corticosteroids
- Mood & Behavioral Fluctuations: Common acute reactions include severe insomnia, euphoria, anxiety, irritability, or restlessness.
- Neuropsychiatric Crises: In sensitive individuals, high doses can precipitate acute confusion, delirium, mania, or steroid-induced psychosis.
Acute psychosis can develop in patients receiving high-dose glucocorticoids.
Immediate cessation of the drug on the appearance of symptoms is required.
Corticosteroid Adverse Effects
Muhammad Yasir 1, Amandeep Goyal 2, Sidharth Sonthalia 3
2023 Jul 3.
Excerpt
Corticosteroids are hormone mediators produced by the cortex of adrenal glands that further categorize into glucocorticoids, mineralocorticoids, and androgenic sex hormones. They are used in a plethora of conditions, commonly called steroid-responsive disorders and dermatoses. Corticosteroids constitute a double-edged sword – significant benefit with a low incidence of adverse effects can be expected if used in proper dosage and for a limited duration; however, wrong dose and/or duration and unmindful withdrawal after prolonged administration can have catastrophic effects. Corticosteroids are used across all medical specialties. This activity reviews the must-know properties of this group of drugs, their broad indications and contraindications, ways of administration, adverse event profile, practical aspects of the pharmacokinetics of different molecules, monitoring essentials, approach to maximize the benefit and minimize adverse effects, and clinically relevant drug-interactions pertinent for all specialists whether used in isolation or administered by an interprofessional team.