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Psychic derangements may appear when corticosteroids are usedranging from euphoriainsomniamood swingspersonality changesand severe depressionto frank psychotic manifestationsAlsoexisting emotional instability or psychotic tendencies may be aggravated by corticosteroids.

Corticosteroids can produce reversible hypothalamic-pituitary-adrenalHPAaxis suppression with the potential for corticosteroid insufficiency after withdrawal of treatmentAdrenocortical insufficiency may result from too rapid withdrawal of corticosteroids and may be minimized by gradual reduction of dosageThis type of relative insufficiency may persist for months after discontinuation of therapythereforein any situation of stress occurring during that periodhormone therapy should be reinstituted.

Co-administration of corticosteroids and warfarin usually results in inhibition of response to warfarinalthough there have been some conflicting reportsThereforecoagulation indices should be monitored frequently to maintain the desired anticoagulant effect.

Because corticosteroids may increase blood glucose concentrationsdosage adjustments of antidiabetic agents may be required.

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