Dr. E. Sherwood Brown of the University of Texas Southwestern Medical Center, Dallas, and colleagues, note that approximately 10 million new prescriptions are written annually in the US for oral corticosteroids. Shortly after the introduction of corticosteroids in the late 1940s, reports began to appear of side effects including depression, mood disturbances and hallucinations.
Studies indicate that the risk for psychiatric symptoms is higher with higher doses.
Cognitive deficits have also been documented even after 4 to 5 days of dexamethasone or prednisone treatment. Other studies have shown no psychiatric symptoms accompanying low doses of oral corticosteroids. There have been occasional reports of psychiatric effects associated with inhaled corticosteroids. Overall, indications are that psychiatric symptoms often appear within the first weeks of corticosteroid therapy. Symptoms are dose dependent and include mania, depression, mood lability and psychosis.