Steroid Withdrawal Psychiatric Syndromes

AbstractIt is well known that alterations in steroid homeostasis can result in psychiatric syndromes. Although much has been written about psychopathology in Cushing's syndrome, Addison's disease, and steroid-induced psychiatric states, steroid withdrawal effects have rarely been discussed in the psychiatric literature, and the question sometimes arises as to whether steroid withdrawal psychiatric syndromes actually exist. We present here two case studies of psychiatric steroid withdrawal states followed by a review of the literature on steroid withdrawal, with particular emphasis placed on a comparison with steroid-induced psychiatric conditions. We tentatively conclude that although there are similarities between steroid-induced and steroid withdrawal psychiatric syndromes there are also potential differences including outcome ana response to treatment. Controlled studies will be required to test these hypotheses. A more intricate understanding of how the limbic-hypothalamic-pituitary-adrenal axis and t...