Steroid-induced psychosis is a known serious adverse effect seen commonly in adults but less commonly in children. We present a seven-year-old girl with steroid-dependent nephrotic syndrome who developed abnormal behaviour, trichotillomania, alopecia and mood changes. She was investigated to rule out other causes and treated with tapering steroids, fluoxetine and olanzapine. A marked improvement was noted after two months. Patients on long term or high dose steroids should be monitored for adverse psychological effects of steroids, as early recognition and intervention can improve the outcome.
DawmanLMehtaASharawatIK, et al.Risk factors for steroid dependency in children with idiopathic nephrotic syndrome in India. Ind J Pediatr2016; 83: 261–261.
2.
DawmanLBhattacharyaDSharawatIK, et al.Lipomatosis of spinal epidural space, peritoneum, and renal sinus: a rare complication of long-term steroid therapy in a child with nephrotic syndrome. Child Nerv Syst2019; 35: 1401–1405.
3.
DubovskyANArvikarSSternTA, et al.The neuropsychiatric complications of glucocorticoid use: steroid psychosis revisited. Psychosomatics2012; 53: 103–115.
4.
LewisDASmithRE. Steroid-induced psychiatric syndromes. A report of 14 cases and a review of the literature. J Affect Disord1983; 5: 319–332.
5.
SwedoSELeonardHLRapoportJL, et al.A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling). N Engl J Med1989; 321: 497–501.
6.
ChandranNSNovakJIorizzoM, et al.Trichotillomania in children. Skin Appendage Disord2015; 1: 18–24.
7.
SharawatIKDawmanL. Toddler with intermittent abnormal behavior: is it isoniazid-induced psychosis?Pediatr Emerg Care2021; 37: e60–e61.
8.
SethAAggarwalA. Monitoring adverse reaction to steroid therapy in children. Ind Pediatr2004; 41: 349–357.
9.
VitielloB. Psychopharmacology for young children: clinical needs and research opportunities. Pediatrics2001; 108: 983–989.
10.
KennaHAPoonAWde los AngelesCP, et al.Psychiatric complications of treatment with corticosteroids: review with case report. Psychiatry Clin Neurosci2011; 65: 549–560.
