Patients prescribed oral steroids are nearly seven times as likely to commit or attempt suicide, say researchers.
In the largest study of its kind, patients on oral glucocorticoids were found to be more likely to experience depression, mania or disorientation compared with controls.
Researchers obtained data for 372,696 adult patients with a variety of conditions, including asthma, registered at UK general practices between 1980 and 2008.
The American Journal of Psychiatry studyÂ was published last month and found 109 incident cases of suicide or suicide attempts and 10,220 incident cases of severe neuropsychiatric disorders in patients prescribed oral steroids.
Patients taking oral steroids were more likely to commit or attempt suicide compared with those with the same underlying medical disease not treated with oral steroids, with a hazard ratio of 6.89.
This group were also twice as likely to suffer from depression – hazard ratio 1.83 - and more than four times as likely to suffer mania – hazard ratio 4.35.
The authors of the study concluded GPs should educate patients and monitor oral steroids closely.
Lead author Dr Laurence Fardet, a consultant in internal medicine at Saint-Antoine Hospital, Paris, called for caution in prescribing oral steroids: 'Where it is essential to prescribe a glucocorticoid, patients and their families should be informed about the possibility of these severe adverse events.’