author={Owen M. Wolkowitz and Heather M. Burke and Elissa S. Epel and Victor I. Reus},
  journal={Annals of the New York Academy of Sciences},
Elevated circulating levels of glucocorticoids are associated with psychiatric symptoms across several different conditions. It remains unknown if this hormonal abnormality is a cause or an effect of the psychiatric conditions. For example, the hypercortisolemia observed in a subset of patients with depression may have a direct impact on the symptoms of depression, but it is also possible that the hypercortisolemia merely reflects the stress associated with depression. Further, rather than… 

Acute Psychosis Following Corticosteroid Administration

Clinicians should be aware of the acute neuropsychiatric side effects of corticosteroids and evaluate patients for delirium if clinically indicated and the use of atypical antipsychotics in the management of these sequelae needs to be explored.

The Relationship Between Cumulative Exogenous Corticosteroid Exposure and Volumes of Hippocampal Subfields and Surrounding Structures.

Cumulative glucocorticoid exposure was negatively associated with left and right hippocampal dentate gyrus/CA3 volume and suggests that the dentategyrus and CA3 regions are particularly vulnerable to those effects, which is consistent with animal models of chronic stress but has not been previously demonstrated in humans.

High Cortisol and the Risk of Dementia and Alzheimer’s Disease: A Review of the Literature

Elevated cortisol levels may exert detrimental effects on cognition and contribute to AD pathology, and further studies are needed to investigate cortisol-reducing and glucocorticoidreceptor modulating interventions to prevent cognitive decline.

Association of glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS): a cross-sectional study

Daily glucocorticoid doses were inversely associated with emotional health among SLE patients in LLDAS, and further studies are needed to determine whether glucoc Corticoid tapering leads to clinically significant improvements in emotional health.

The Effect of Probiotic Intervention in Ameliorating the Altered Central Nervous System Functions in Neurological Disorders: A Review

The potential of probiotics as an important dietary modification as well as a useful intervention therapy with preventive and therapeutic value for the target population holds strong but future evaluation into formulation designing, selecting the best probiotic strain(s) for each specific disease and safety and tolerability aspects in patients needs to be considered.

Management of Psychosis in Neuropsychiatric Lupus

  • D. KangC. Mok
  • Psychology, Medicine
    Journal of Clinical Rheumatology and Immunology
  • 2019
Acute psychosis is an uncommon but well-recognized manifestation of NPSLE and with no specific biomarkers to identify, there is no specific treatment strategy to treat it.



Steroids and depression

  • B. Murphy
  • Medicine, Psychology
    The Journal of Steroid Biochemistry and Molecular Biology
  • 1991

Do Glucocorticoids Have Adverse Effects on Brain Function?

The risk of memory impairment should be carefully considered before initiating treatment with glucocorticoids and their use should be considered in the differential diagnosis of memory loss.

Association of depression with medical illness: does cortisol play a role?

Neurosteroids, brain damage, and mental illness

  • J. Herbert
  • Biology, Psychology
    Experimental Gerontology
  • 1998

Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders.

  • R. Sapolsky
  • Psychology, Biology
    Archives of general psychiatry
  • 2000
This review examines the evidence for hippocampal atrophy in Cushing syndrome, which is characterized by a pathologic oversecretion of glucocorticoids; (2) episodes of repeated and severe major depression; (3) posttraumatic stress disorder and what cellular mechanisms underlie the overall decreases in hippocampal volume.

Antiglucocorticoid drugs in the treatment of depression

Developing drugs specifically targeting the glucocorticoid receptor may lead to innovative strategies in the treatment of mood disorders and stabilise mood through actions on the hypothalamic-pituitary adrenocortical (HPA) system.

When not enough is too much: the role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders.

Neuroendocrine data provide evidence of insufficient glucocorticoid signaling in stress-related neuropsychiatric disorders, including posttraumatic stress disorder and major depression, which are associated with immune system activation/inflammation, high SNS tone, and CRH hypersecretion.

Glucocorticoid Medication, Memory and Steroid Psychosis in Medical Illness

From a clinical prospective, it is important to discuss potential neuropsychiatric side effects with patients before prescribing GC treatment, and a greater understanding of the risk factors for experiencing SP and of its underlying mechanisms will lead to more informed clinical decision making.