An open-label trial of olanzapine for corticosteroid-induced mood symptoms.
BACKGROUND
Prescription corticosteroids are given for a variety of common medical conditions. Psychiatric symptoms including depression, psychosis, and especially mania are common side effects of corticosteroid therapy. However, minimal data are available on the treatment of corticosteroid-induced psychiatric symptoms.


METHODS
In this study, 12 outpatients with manic or mixed symptoms secondary to corticosteroids were enrolled in a 5-week prospective, open-label trial of olanzapine. Psychiatric symptom measures included the Hamilton Rating Scale for Depression (HRSD), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS). Side effects were monitored with the Simpson Angus Scale (SAS), Abnormal Involuntary Movement Scale (AIMS), and Barnes Akathisia Scale (BAS). Weight and blood glucose were obtained at baseline and exit. Olanzapine dosing was flexible beginning at 2.5 mg/day and titrated upward as necessary to a maximum dose of 20 mg/day. Data were analyzed with Wilcoxon signed rank tests using baseline and exit data on all 12 participants.


RESULTS
Participants showed significant reductions in YMRS (primary outcome measure), HRSD, and BPRS scores with no significant change in the SAS, AIMS, BAS, weight, or blood glucose levels. One participant discontinued early due to lack of efficacy.


CONCLUSIONS
These data suggest that olanzapine is well tolerated and appears to be useful for mood disturbances associated with corticosteroid therapy. Controlled trials seem warranted to confirm these observations.
Brown
E Sherwood
ES
Department of Psychiatry, Southwestern (STARS) Program at the University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8849, USA. Sherwood.Brown@UTSouthwestern.edu
Chamberlain
Wendy
W
Dhanani
Nafisa
N
Paranjpe
Pooja
P
Carmody
Thomas J
TJ
Sargeant
Michael
M
D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000139:chemically induced* / Q000188:drug therapy; D003866:Depressive Disorder / Q000139:chemically induced* / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D000077152:Olanzapine; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D013781:Texas; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine; D011241:Prednisone