When corticosteroid risks come up, most clinicians immediately think about osteoporosis, hyperglycemia, infection risk, or adrenal suppression. But what about the organ sitting between the ears? In this episode of the JDD Podcast‘s Corticosteroid Stewardship Series, host Dr. Adam Friedman welcomes Lucinda Whitney, DNP, APRN, PMHNP-BC, Clinical Assistant Professor and PMHNP Program Coordinator at the University of Kansas School of Nursing, for a conversation that shines a much-needed spotlight on one of corticosteroids’ most overlooked toxicities: their effects on mental health.
From subtle insomnia, irritability, and anxiety to mania, depression, and psychosis, psychiatric complications remain one of the least anticipated and, unfortunately, least discussed consequences of systemic corticosteroid therapy. Together, Dr. Friedman and Dr. Whitney explore why these effects continue to fly under the radar, why the seemingly harmless “steroid burst” deserves a second look, and how cumulative exposure can quietly reshape a patient’s psychiatric risk profile over time. The discussion moves beyond identifying complications to providing practical strategies clinicians can implement immediately: incorporating routine mental health screening before prescribing, recognizing early warning signs, counseling patients and families without creating unnecessary alarm, and building interdisciplinary partnerships that make corticosteroid stewardship a true team sport. Tune in for an evidence based, clinically practical conversation that reminds us that good corticosteroid stewardship means treating the whole patient, not just the inflammation.
