In most patients, there is an initial feeling of well-being induced by steroids, particularly at lower doses. However, mood elevation often is replaced by irritability with continued administration, particularly at higher doses. Psychotic behavior may follow simple mood elevation. Frank manic psychosis occurs in a small proportion of patients treated with steroids by any route of administration. Mood elevation can be managed using lithium carbonate and diazepam. Although it is the more common response, other patients may become depressed. ACTH may also occasionally be associated with these mood changes.
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