The following is a summary of “Neuropsychiatric Adverse Effects of Synthetic Glucocorticoids: A Systematic Review and Meta-Analysis,” published in the June 2024 issue of Endocrinology by Koning, et al.
Synthetic glucocorticoids are commonly utilized in the treatment of various diseases but are associated with neuropsychiatric adverse effects. For a systematic review and meta-analysis, researchers sought to assess and quantify the prevalence of neuropsychiatric adverse effects in patients receiving synthetic glucocorticoids.
About 6 electronic databases were systematically searched to identify relevant studies. Eligible studies included randomized controlled trials, cohort studies, and cross-sectional studies assessing psychiatric side effects of glucocorticoids using validated questionnaires. The risk of bias was evaluated using RoB 2, ROBINS-I, and the AXIS appraisal tool. Proportions of neuropsychiatric outcomes were pooled, and differences in questionnaire scores between glucocorticoid users and nonusers were expressed as standardized mean differences (SMD). Data were synthesized using random-effects logistic regression models.
Around 49 studies were included, revealing heterogeneity in study populations, glucocorticoid types, doses, and durations. Meta-analysis showed proportions of neuropsychiatric outcomes among glucocorticoid users: depression (22%, 95% CI 14%-33%), mania (11%, 2%-46%), anxiety (8%, 2%-25%), delirium (16%, 6%-36%), and behavioral changes (52%, 42%-61%). Questionnaire scores for depression (SMD 0.80, 95% CI 0.35-1.26) and mania (SMD 0.78, 95% CI 0.14-1.42) were higher in glucocorticoid users compared to controls, indicating increased depressive and manic symptoms following glucocorticoid use.
Despite the heterogeneity in glucocorticoid usage across studies, a high prevalence of neuropsychiatric adverse effects was observed in glucocorticoid users, particularly for depression and mania. Clinicians should be vigilant about potential psychiatric side effects when initiating glucocorticoid therapy. Further research with structured methodologies was warranted to explore the incidence and mechanisms underlying neuropsychiatric side effects associated with prescribed glucocorticoids.
Reference: academic.oup.com/jcem/article/109/6/e1442/7457344
The post High Prevalence of Adverse Neuropsychiatric Effects in Synthetic Glucocorticoids Users first appeared on Physician's Weekly.