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.
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.
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