Steroids are diverse compounds with varied effects. The question of whether they can cause hallucinations often arises. Understanding specific steroid types is important for their potential psychiatric effects. This article explores which types are linked to hallucinations and the underlying reasons.
Types of Steroids
The term “steroids” encompasses several classes of compounds, but two main types are relevant when discussing psychiatric side effects: anabolic-androgenic steroids (AAS) and corticosteroids. Anabolic steroids (AAS) are synthetic testosterone derivatives, known for muscle-building and masculinizing properties. They are often misused for performance enhancement. While AAS use can cause mood disturbances, aggression, mania, or depression, they are not typically linked to hallucinations.
Corticosteroids, like prednisone and dexamethasone, are a distinct class. They are widely prescribed to reduce inflammation and suppress the immune system, treating conditions like asthma, autoimmune diseases, and certain cancers. Corticosteroids have a more established link to psychiatric symptoms, including hallucinations.
Psychiatric Effects of Corticosteroids
Corticosteroids can induce a spectrum of psychiatric symptoms, from subtle mood changes to severe psychotic reactions. Hallucinations, perceiving things not actually present, are among the more severe effects. These include seeing, hearing, or feeling things that do not exist. Delusions, fixed false beliefs, may also occur.
Beyond hallucinations, individuals might experience significant mood changes, such as euphoria, increased irritability, anxiety, or severe depression. Manic symptoms, characterized by elevated mood, increased energy, and reduced need for sleep, can also develop. Cognitive disturbances, like confusion, memory problems, and difficulty concentrating, are also side effects. These effects vary widely and are not universally experienced.
Why These Effects Occur
Corticosteroids’ psychiatric effects stem from their influence on brain chemistry and function. They can disrupt neurotransmitter balance, chemical messengers in the brain. They alter dopamine and serotonin levels and activity, involved in mood, perception, and cognition. Changes in these systems contribute to mood instability and psychotic symptoms.
Corticosteroids also affect the brain’s stress response system (HPA axis), leading to dysregulation of stress responses. Higher doses and longer treatment durations increase psychiatric symptom risk. Even at lower doses, some individuals experience these effects due to susceptibility or pre-existing mental health conditions. Symptoms can emerge within days of starting treatment, after prolonged use, or during withdrawal.
What to Do if Symptoms Appear
If psychiatric symptoms, including hallucinations, appear while taking corticosteroids, seek medical attention immediately. Never abruptly stop corticosteroid medication without consulting a doctor. Discontinuing these drugs suddenly can lead to serious health complications, including adrenal crisis. Healthcare providers can assess the situation and determine the appropriate course of action.
Managing corticosteroid-induced psychiatric symptoms often involves careful dosage adjustment, potentially reducing it gradually if medically feasible. If symptoms are severe or the corticosteroid cannot be tapered, additional medications like antipsychotics or mood stabilizers may be prescribed. Close monitoring by a healthcare professional is important for patient safety and optimizing treatment outcomes.