Steroids can increase risk of mental health issues by ‘changing shape of brain’ - Study

Glucocorticoid drugs are synthetic versions of glucocorticoids, which are steroids that occur naturally in the body. According to WebMD, glucocorticoid is a kind of steroid, and the type you need depends on the specific health condition you have.

Synthetic glucocorticoids can be more potent than naturally occurring steroids and these drugs are effective in stopping harmful inflammation caused by many immune system disorders in the body.

Media reports inform that millions of Britons are prescribed steroids to treat a wide range of conditions such as arthritis, chronic obstructive pulmonary disease (COPD), eczema, and asthma.

However, a study has discovered that glucocorticoids (one type of drug which is often used to treat autoimmune and inflammatory skin diseases) may physically change the shape and structure of the brain as well as potentially increase the risk of mental health issues, The Telegraph reports.

Though previously, the prolonged use of systemic glucocorticoids had been linked to potential side effects in the long term, there has been little research to prove such a connection exists.

The study has now discovered that prescribed steroids have been linked to an increased risk of depression and tiredness, including other health concerns.

Steroids are also supposedly prescribed to dampen the immune system in people with autoimmune disorders - a malfunction of the immune system, whereby it mistakenly attacks healthy body tissues, cells, and organs.

For the study, scientists from Leiden University in the Netherlands looked at how systemic (infusion or tablet) and inhaled glucocorticoids affected people over time.

Nearly 800 patients, most in their 60s (part of the UK Biobank study) were enrolled in the research. The researchers were reportedly equipped with MRI images of the participants’ brains as well as their extensive medical records.

The brains of the 800 patients were then compared to more than 24,000 other people (of similar health, age, and demographic) to check for any differences in grey and white matter in their brains.

It was found that both, the use of systemic and inhaled glucocorticoids was associated with physically different white and grey matter in the brains.

However, systemic administration (infusion or tablet) of the drugs reportedly showed a stronger association.

The study, which is published in the journal BMJ Open, states that systemic use of glucocorticoids was associated with larger grey matter volume in the caudate structure in the brain - the caudate nucleus functions in learning, planning, memory, reward, motivation, emotion, etc.

But on the other hand, the users who inhaled glucocorticoids were found to have smaller amygdala grey matter volume. Studies have demonstrated that smaller grey matter volumes in the amygdala are associated with a wide range of negative emotions such as depression.

The researchers said they are unable to say whether steroids cause brain changes due to the design of the study, however, they do say it is likely in light of the new data and previous reports.

Writing in their paper, the authors have reportedly said, “This study shows that in the large population-based cohort of the UK Biobank, the use of not only systemic glucocorticoids but also inhaled glucocorticoids is associated with changes in several brain imaging parameters.”

They add, “Analyses among people using chronic glucocorticoids suggested a potential dose-dependent or duration-dependent effect of glucocorticoids on white matter microstructure, with smallest effect sizes in inhaled glucocorticoid users, larger effect sizes in systemic glucocorticoid users, and the largest effect sizes in chronic systemic glucocorticoid users.”

Data from the study shows that those people on systemic steroids (infusion or tablet) are 76 per cent more likely to have depressive symptoms. They are also 90 per cent more likely to suffer from lethargy.

It was also found that those on systemic steroids are 84 per cent more at risk of reporting struggling with disinterest and 78 per cent more likely to be restless.

But people on inhaled steroids were found to be 35 per cent more likely to be tired or lethargic with no higher risk for other conditions.

However, the researchers were reportedly unable to differentiate between people (on tablets and infusions).

According to the authors of the study, these findings are “remarkable” considering the widespread use of prescribed steroids. Thus, they believe there is a need for more awareness of the association between the treatments and the potential neuropsychiatric side effects.

Speaking about the side effects of the steroids on the patients’ brains they reportedly said, “In this study, glucocorticoid users reported a higher frequency of several mental health complaints, while their cognitive performance was not significantly different.”

They add, “To the best of our knowledge, this is the largest study to date assessing the association between glucocorticoid use and brain structure, and the first to investigate these associations in inhaled glucocorticoid users.”