Miloslavsky et al evaluated significant adverse risk effects of glucocorticoid therapy. The authors are from multiple institutions in North America and Europe.
Patient selection: glucocorticoid therapy
Parameters:
(1) insomnia
(2) mania
(3) cognitive impairment
(4) depression
Parameter
Finding
Severity
insomnia
none
none
not associated with functional impairment
mild
associated with functional impairment
moderate
mania
none
none
Grade 1
mild
Grade 2
moderate
Grade 3
severe
cognitive impairment
none
none
Grade 1 (minor)
mild
Grade 2 (moderate cognitive deficits)
moderate
Grade 3 (delirium)
severe
depression
none
none
Grade 1
mild
Grade 2
moderate
Grade 3
severe
Symptoms of mania:
(1) elevated or irritable mood
(2) inflated self-esteem
(3) decreased need for sleep
(4) increased talkativeness
(5) feeling that thoughts are faster than usual
(6) distractibility
(7) increased activity
(8) agitation
(9) impulsive actions
Symptoms of depression:
(1) loss of interest
(2) low energy
(3) guilt
(4) poor concentration
(5) insomnia
(6) restlessness
(7) change in appetite
(8) suicidal thoughts
To read more or access our algorithms and calculators, please log in or register.
