Prevention of Steroid-Induced Neuropsychiatric Complications With Neuroleptic Drugs: A Review

Ivy Akid, Suzanne Nesbit, Julie Nanavati, Oscar Joseph Bienvenu, Thomas J. Smith

Research output: Contribution to journalArticlepeer-review


Corticosteroids are used for a multitude of indications in palliative patients. In this narrative review, we aim to review literature on the treatment and prevention of neuropsychiatric complications of steroids. For prevention, only lamotrigine had a positive effect in a small number of studies. For treatment, olanzapine appears to be nearly universally effective at low doses, but randomized trial evidence is lacking. Further randomized clinical trials are necessary to elucidate data-driven guidelines for prevention and treatment of corticosteroid-induced neuropsychiatric symptoms. Until further data are available, it is reasonable to consider low dose olanzapine for any patient taking 40 mg of prednisone or its equivalent, especially those with a history of depression or neuropsychiatric symptoms.

Original languageEnglish (US)
Pages (from-to)472-476
Number of pages5
JournalAmerican Journal of Hospice and Palliative Medicine
Issue number4
StatePublished - Apr 2022


  • complications
  • corticosteroids
  • neuroleptics
  • neuropsychiatric
  • olanzapine
  • palliative care
  • prevention
  • treatment

ASJC Scopus subject areas

  • Medicine(all)


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