- Case report
- Open Access
Steroid psychosis in a polyarteritis nodosa patient successfully treated with risperidone: tracking serum brain-derived neurotrophic factor levels longitudinally
© Yoshimura et al; licensee BioMed Central Ltd. 2012
- Received: 27 December 2011
- Accepted: 23 January 2012
- Published: 23 January 2012
We previously reported a case in which steroid-induced psychosis was eliminated with risperidone treatment in a patient with polyarteritis nodosa (PN). In the present report, we longitudinally tracked the serum levels of brain-derived neurotrophic factor (BDNF). We found that corticosteroid lowered serum BDNF levels, and improvement of psychiatric symptoms was intact with the serum BDNF levels seen in the patients.
- Psychiatric Symptom
- Brief Psychiatric Rate Scale
- Polyarteritis Nodosa
There are several reports demonstrating the effectiveness of risperidone in treating steroid psychosis [1, 2]. We have also previously demonstrated that risperidone did not change serum brain-derived neurotrophic factor (BDNF) levels in patients with schizophrenia . BDNF is associated with psychiatric diseases such as depression or schizophrenia . In the present case, risperidone rapidly diminished our patient's psychiatric symptoms without severe adverse effects. Corticosteroids suppress BDNF levels in the brain, which leads to atrophy of the hippocampus . To the best of our knowledge, this is the first report showing longitudinal tracking of serum BDNF levels in a case of steroid psychosis in a patient with polyarteritis nodosa (PN).
Corticosteroid reduced serum BDNF levels and kept those levels lower, and risperidone did not cause the serum BDNF levels to recover. In addition, risperidone is effective for use in steroid psychosis patients with PN, and improvement of psychotic symptoms in the patient was independent of serum BDNF levels.
Written informed consent was obtained from the patient for publication of this case report.
The authors thank Ms Kazuko Shimizu for her technical assistance in analyzing serum BDNF.
- Kato O, Misawa H: Steroid-induced psychosis treated with valproic acid and risperidone in a patient with systemic lupus erythematosus. Prim Care Companion J Clin Psychiatry. 2005, 7: 312-10.4088/PCC.v07n0610b.PubMed CentralView ArticlePubMedGoogle Scholar
- Ulamtinon S, Tzuang D, Dahl G, Shaw RJ: Concurrent treatment of steroid-related mood and psychotic symptoms with risperidone. Pediatrics. 2010, 125: 1241-1245. 10.1542/peds.2009-1815.View ArticleGoogle Scholar
- Yoshimura R, Hori H, Sugita A, Ueda N, Kakihara S, Umene W, Shinkai T, Nakamura J: Treatment with risperidone for 4 weeks increased plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) levels, but did not alter plasma brain-derived neurotrophic factor (BDNF) levels in schizophrenic patients. Prog Neuropsychopharmacol Biol Psychiatry. 2007, 31: 1072-1077. 10.1016/j.pnpbp.2007.03.010.View ArticlePubMedGoogle Scholar
- Duman RS, Heninger GR, Nestler EJ: A molecular and cellular therapy of depression. Arch Gen Psychiatry. 1997, 54: 597-606. 10.1001/archpsyc.1997.01830190015002.View ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.