Q: How early psychosis can hit with steroid therapy?

Answer: As early as 4 days

Psychiatric symptoms may develop as soon as after 4 days of corticosteroid therapy, although they can occur anytime in therapy or even after treatment ends. High corticosteroid dose is the primary risk factor for psychosis.

Primary treatment is tapering off steroid along with various antipsychotic drugs if needed.

Further reading:

1. Warrington TP, Bostwick JM. Psychiatric adverse effect of corticosteroids. Mayo Clin Proc. 2006;81(10):1361-1367

2. Sirois F. Steroid psychosis: a review. Gen Hosp Psychiatry. 2003;25:27-33.

3.  Hall RC, Popkin MK, Stickney SK, et al. Presentation of the steroid induced psychosis. J Nerv Ment Dis. 1979;167:229-236