‘Steroïdpsychose’ bij behandeling van dreigende vroeggeboorte

A 30-year-old woman, 33 weeks pregnant, without a significant psychiatric history, was admitted for treatment of premature labour. She was treated with betamethasone intramuscularly, with a total dose of 24 mg divided over 2 days, and nifedipine orally with beneficial effect on the contractions. However, within 24 h after completion of tocolytic treatment, she developed a psychosis with delusions and hallucinations necessitating readmission, first to an obstetric ward, later to a psychiatric ward. At least part of this episode may be characterized as delirium. Eventually, she was treated with haloperidol. It is argued that her psychosis was caused by the corticosteroid, since psychiatric disturbance is a well-known complication of corticosteroid therapy. To our knowledge, psychosis during pregnancy as a result of treatment with corticosteroids has not been reported previously.

Conflict of interest: none declared. Financial support: A.R. Van Gool received payment for lectures and consultancy and partial reimbursement of meeting expenses, none of which related to this publication, from Schering-Plough, Lundbeck, Astra Zeneca, BMS and Wyeth.