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ACG Case Rep J. 2017; 4: e11.
Published online 2017 January 18. doi:  10.14309/crj.2017.11
PMCID: PMC5247628

Steroid-Induced Psychosis after EUS-Guided Celiac Plexus Blockade


A 46-year-old female with no previous personal or family psychiatric history underwent endoscopic ultrasound (EUS)-guided celiac plexus blockade (CPB) to treat pain related to cystic fibrosis transmembrane conductance regulator-associated chronic pancreatitis. She had excellent response to her first three CPBs using bupivacaine and triamcinolone. The patient’s subsequent CPBs were complicated by symptoms of racing thoughts, delusional thinking, and insomnia. She was diagnosed with acute psychosis secondary to triamcinolone. This is the first reported case of steroid-induced psychosis caused by EUS-guided CPB. Optimal treatment for steroid-induced psychiatric symptoms include dose reduction or discontinuation of steroids and administration of lithium, valproic acid, or atypical antipsychotics.

Articles from ACG Case Reports Journal are provided here courtesy of American College of Gastroenterology