In delirium management, if corticosteroids are needed, what dosing approach is recommended?

• A. Use the lowest possible dose for the shortest duration and monitor for delirium
• B. Use the highest possible dose for the shortest duration
• C. Avoid entirely
• D. Use for long duration

Answer: (A)

When corticosteroids are needed, the priority is to minimize exposure because steroids can trigger delirium and other neuropsychiatric effects, especially in older adults. Using the lowest effective dose for the shortest possible duration minimizes this risk, and ongoing monitoring for delirium allows for quick adjustment if symptoms arise. If a longer course is truly necessary, plan careful tapering and regular reassessment. Higher doses, avoiding steroids entirely when they’re indicated, or using steroids for a long duration all increase the risk of delirium and other adverse effects.