A case of steroid-induced depression improved by modified electroconvulsive therapy

Abstract

Steroid psychosis is a well-known mental disorder; it is one of the side effects of taking adrenocortical steroid drugs. We present the case of a male who developed steroid psychosis and was successfully treated by modified electroconvulsive therapy (m-ECT). Our case was a 23-year-old male with no psychiatric history. He was initially active; however, he developed depressive illness after steroid pulse therapy for nephrotic syndrome. His depressive symptoms persisted even after discontinuation of steroids; internal medications of antidepressants and antipsychotic drugs were initiated, but the symptoms did not improve. However, the symptoms dramatically improved by m-ECT. After m-ECT, he was transitioned to lamotrigine for maintenance therapy. We report the case of a patient with depressive illness who did not improve even after steroid discontinuation, possibly representing a steroid psychiatric disorder due to drug resistance. The maintenance therapy was successful, indicating that mood stabilizers could be effmective. m-ECT is a valid treatment method for treating steroid psychosis.