In an unusual case, a woman in her late 50s, previously diagnosed with an organic bipolar 1-like affective disorder, experienced steroid-induced mania following chemotherapy for breast cancer. The patient had been stable on her psychiatric medication, including lithium and lamotrigine but developed manic symptoms after receiving high-dose dexamethasone as part of her chemotherapy regimen. The case also delves into the patient’s past medical history, including a severe brain injury and the development of an organic affective disorder, which was characterized by both depressive and manic episodes and was difficult to treat. The patient’s family history revealed a maternal diagnosis of bipolar affective disorder, suggesting a hereditary component to her condition. The patient’s response to the steroid treatment – manifested as manic symptoms – was resolved upon altering her chemotherapy regimen and administering clonazepam. This case underscores the potential risk factors and complexities in treating patients with mood disorders, particularly those who are receiving steroid treatment.
Reference: King JD, Elliott T, Pitman A. Steroid-induced mania in a patient with previously well-controlled organic bipolar 1-like affective disorder secondary to acquired brain injury: case report and literature review. Discov Ment Health. 2024 Mar 8;4(1):8. doi: 10.1007/s44192-024-00061-w. PMID: 38453827; PMCID: PMC10920485.
