Corticosteroid-related central nervous system side effects

Corticosteroids have been used since the 50s as anti-inflammatory and immunosuppressive drugs for the treatment of several pathologies such as asthma, allergy, rheumatoid arthritis, and dermatological disorders. Corticosteroids have three principal mechanisms of action: 1) inhibit the synthesis of i...

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Published inJournal of pharmacology & pharmacotherapeutics Vol. 4; no. Suppl 1; pp. S94 - S98
Main Authors Ciriaco, Miriam, Ventrice, Pasquale, Russo, Gaetano, Scicchitano, Maria, Mazzitello, Giovanni, Scicchitano, Francesca, Russo, Emilio
Format Journal Article
LanguageEnglish
Published India Medknow Publications and Media Pvt. Ltd 01.12.2013
Sage Publications Ltd
Medknow Publications & Media Pvt Ltd
Subjects
Case Review
Case studies
Central nervous system diseases
Complications and side effects
Corticosteroids
Risk factors
Adverse effects
corticosteroids
mood
psychosis
central nervous system
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Summary:Corticosteroids have been used since the 50s as anti-inflammatory and immunosuppressive drugs for the treatment of several pathologies such as asthma, allergy, rheumatoid arthritis, and dermatological disorders. Corticosteroids have three principal mechanisms of action: 1) inhibit the synthesis of inflammatory proteins blocking NF-kB, 2) induce the expression of anti-inflammatory proteins by IkB and MAPK phosphatase I, and 3) inhibit 5-lipoxygenase and cyclooxygenase-2. The efficacy of glucocorticoids in alleviating inflammatory disorders results from the pleiotropic effects of the glucocorticoid receptors on multiple signaling pathways. However, they have adverse effects: Growth retardation in children, immunosuppression, hypertension, hyperglycemia, inhibition of wound repair, osteoporosis, metabolic disturbances, glaucoma, and cataracts. Less is known about psychiatric or side effects on central nervous system, as catatonia, decreased concentration, agitation, insomnia, and abnormal behaviors, which are also often underestimated in clinical practice. The aim of this review is to highlight the correlation between the administration of corticosteroids and CNS adverse effects, giving a useful guide for prescribers including a more careful assessment of risk factors and encourage the use of safer doses of this class of drugs.
ISSN:0976-500X
0976-5018
DOI:10.4103/0976-500x.120975