One of my relatives was recently diagnosed with steroid psychosis a year and a half after taking a steroid asthma inhaler for asthma (on and off). His family never knew, since he kept his delusions secret. However, it eventually came out in other ways. Please watch for this in your own family and friends who take steroids for asthma. I had never heard about side effects from asthma inhalers until now, but apparently its well known among psychiatrists.
Here is some information I found while researching the subject. I hope it helps someone:
"Asthma inhalers and nasal sprays that contain steroids are well known to cause psychiatric side effects such as depression, mood swings, aggression, irritability and insomnia. However, in rare cases, they can also cause a side effect called "steroid psychosis". People with steroid psychosis lose contact with reality and can appear to be crazy or insane. Symptoms of steroid psychosis can involve anything from incoherent babbling to psychotic delusions and hallucinations. The person may need to be hospitalized and treated with anti-psychotic drugs. The condition is usually reversible, although it may take weeks, months, or even longer to resolve. Steroid psychosis is rare with steroid asthma inhalers and nasal sprays (1 in 10,000 chance). However, it is much more common with oral (pills) steroid drugs, such as prednisone.
Examples of steroid asthma inhalers are Pulmicort, Flovent and Advair. Examples of steroid nasal sprays are Nasonex, Nasacort, Rhinocort and Flonase.
Steroid psychosis can begin with a feeling of being 'hyped up'. This can be followed by anxiety, tachycardia (rapid heart beat), pressured speech, increased blood pressure, loss of potassium, severe insomnia, depression, hallucinations, memory problems and delusions. The person can appear to have serious mental illness, such as bipolar mania or schizophrenia, which are mental illnesses characterized by the loss of contact with reality. People with steroid psychosis may experience suicidal or homicidal ideation (thoughts of killing themselves or others). They can have delusions of grandeur (a false belief they have great importance), such as believing they are Jesus Christ. They can also have paranoid delusions (a false belief they are being persecuted), such as believing they are the victim of a conspiracy. Also, the person may experience hallucinations or visual illusions. The hallucinations can be visual (seeing people or things that are not there), or auditory (hearing voices). Steroid psychosis can leave a person disabled and unable to work.
Note that the steroids in asthma inhalers are called "corticosteroids", and should not be confused with the steroids used by body builders called "anabolic steroids".