Are you , or have you ever been diagnosed or treated for Bipolar or other forms of Mental Health issue?
Psychosis has been known to be more common as a side effect on Steroid Treatment with certain Mental Health issues or treatments , which is why people with these issues are often monitored more carefully on Steroid Treatments.
Behavioural Changes , less commonly Medical Psychosis, can be a side effect , unfortunately , for some people using Steroids at higher doses. It is also possible to suffer episodes of Anger , Mood Swings , and Brain Fog or Absences in recollection of your short term actions but not necessarily Psychosis.
If you are unsure if you are suffering from any of the side effects but have concerns it would be wise to speak to your GP or Specialist as soon as possible and organise an appointment to discuss what they advise you to do next. They may require you to have some tests to rule out other causes and keep a record of your behaviour before making a decision.
If you don't usually take your wife with you into an appointment it may be a good idea for her to attend on this occasion as she is the person whom has apparently witnessed these episodes that you may have forgotten and could give them more details that would be useful for them to make an opinion.
Don't forget , although you are taking Steroids , if you are having a behaviour change , it may not be because of the Steroids but something else , so it is worth checking out in case there is a simple solution separate from your PMR treatment.
Please keep us updated and I hope things are sorted out soon.
Psychiatric adverse effects during systemic corticosteroid therapy are common.
Two large meta-analyses found that severe reactions occurred in nearly 6% of patients, and mild to moderate reactions occurred in about 28%. Although disturbances of mood, cognition, sleep, and behavior as well as frank delirium or even psychosis are possible, the most common adverse effects of short-term corticosteroid therapy are euphoria and hypomania. Conversely, long-term therapy tends to induce depressive symptoms
Corticosteroid withdrawal syndrome presents most commonly with depression, anxiety, and fatigue,66 but mania68 and delirium69 have also been described. If patients develop intolerable withdrawal symptoms from a dose reduction, a temporary dose increase with a slower taper is advised. Symptoms of corticosteroid withdrawal syndrome generally resolve over 2 to 8 weeks.11, 43 A slower taper can be attempted after resolution of withdrawal symptoms.68 "
Definitely important to have it assessed , what you may be displaying may not be as extreme as Psychosis but mood swings , and some behavioural Changes , more common to steroid use or hormonal changes .
Steroid use , especially when you first start them , in the first days of a Taper or at higher doses above 10 mg can bring the sort of mood changes that are common to things like the Menopause , Pregnancy or PMS or Excess Testosterone and Adrenaline.
Women are more likely to recognise these changes in themselves and become less alarmed by it because we are taught from an early change to look for behaviour changes that may come with hormone changes.
Men aren't taught to look for the links , and women aren't taught to look for them in Men , so if their Partners start to display these mood behaviour changes , especially if the Man themselves has always been a calm or quiet individual the change can seem more alarming and may be perceived as more extreme than it is.
It does need recognising and addressing by the person suffering it so that they can reduce the severity and incidents of mood swings with behavioural techniques.
It can be quite frustrating , and again , Women are more likely to have experienced the frustration over the years of being accused of being " crazy" or " snappy " and irrational by people around them at times of Menstrual Changes when sometimes they were just Angry or Frustrated for good reason .
Your mood changes and behavioural changes themselves may be so small , and just a split second response, which is unusual to you both things may make it harder for you to recognise that it is happening at all.
Many things like Brain Fog , Zoning Out and more alert physical responses are common with Steroids without behaviour changes too. These also reduce as doses reduce , or as you learn to recognise it and use more relaxation techniques .
When you get used to and accept your illness , and become more Patient with yourself , your illness, and coping with other people's reaction to your illness these episodes also reduce.
The early days of these illnesses can bring less Patience because you are dealing with the burden of the illness or Pain and Fatigue . Just like anybody whom has had a hard day, and may be sore or tired, we are more inclined to be more sensitive to things that frustrate or annoy us and react more aggressively to behaviour or comments that annoy or upset us than we would usually do.
We are always advising Patience and Quick Calming Techniques on the forum to help with this. ' Count to Ten and Think Again ' when you feel like reacting to someone negatively or angrily. 'Is it what you really feel it or a response from Drugs or the Pain?" is a question we get used to asking ourselves before reacting to people or things happening around us.
Learning to accept and recognise that it happens and is normal , but needs controlling , helps.
Things like over alert behaviour and zoning out which have more physical changes rather than behavioural ones can be helped by Relaxation Techniques , and it helps if those around us are aware of these symptoms and we accept their help to be aware we may have these if we aren't responding to the changes ourselves. Going to sit and take some Calm Rest and Breathing Time if we are displaying them helps alot and stops these things translating into Anger or Anxiety and then Tension and Physical Pain.
It's just if this behaviour gets beyond our control or more aggressive , frequent or extreme , , or we genuinely don't remember doing it even when we are looking for the warning signs, that we need to seek extra Medicinal help but discussing it with a Doctor just so it's on your record if you need help later is a positive step .
I am suffering similar symptoms: violent and unpredictable mood swings, sudden sobbing fits, irrational anger etc. As it’s all listed in the PIL for Prednisolone, I reported to my GP, but he wasn’t interested.
I’m sure the sleep deprivation is implicated somewhere along the line as well.
Either way, it’s horrible for the person suffering and probably more so for their nearest and dearest. I’m just hoping it will pass as my dose, currently 50mg, gets lowered.
If you have such symptoms then you need to discuss it with your doctors. Pred CAN cause mental effects as serious as psychosis but many of the things you describe are not uncommon with higher doses of pred in particular.
But the point is that I started on pred at 60 mg one year ago and am stepping down and currently at 7/8 mg as per dsns method. Though I did have such episodes a few times in the past they are still occurring at the said lower doses.
You are at a critical place in the pred taper at 7/8 mg since the adrenal glands need to start working at around 7.5mg to produce cortisol. Perhaps you are having symptoms caused by adrenal insufficiency. If that is the case you could try following the advice in the Mayo Clinic reference I previously gave, to temporarily increase the pred to say 10mg to see if that
resolves the problem. If so, resume taper at 0.5mg/mo. If it doesn't help in 5 days go back to previous dose and no harm is done. Repeating the reference from Mayo Clinic:
"CORTICOSTEROID WITHDRAWAL
.................................
Corticosteroid withdrawal syndrome presents most commonly with depression, anxiety, and fatigue,66 but mania68 and delirium69 have also been described. If patients develop intolerable withdrawal symptoms from a dose reduction, a temporary dose increase with a slower taper is advised. Symptoms of corticosteroid withdrawal syndrome generally resolve over 2 to 8 weeks.11, 43 A slower taper can be attempted after resolution of withdrawal symptoms.68 "
My dad had a very similar reaction. He experienced mania at high doses and many of the symptoms you described as he started to taper. It has all leveled out for him and he's fine now. Hoping you can get some relief!
Hi there, I have twice during the last 6 years after being diagnosed with PMR and GCA had to take at the start and at the relapse a dose of 80 mg. prednisone. The first time I had no problems other than swelling of face, however a year ago I had to go back to 80 mg and had extreme anxiety to the point of a visit late at night to the emergency dept of my local hospital. I have never had any problems before and so was extremely worried. They assured me that it was the pred and prescribed 5mg twice a day of buspirone. A mild calming agent. Immediately I was normal again and I still take that and have had no further problems.I am almost 82 and am still working and enjoy life, don't get discouraged, you will come through it ,and I wish you well. I live in the States but am British and am aware that sometimes your meds are under a different name and so not sure if Buspirone would be named something else.
Hi again, I have found this site to be of great help tp me. I was first diagnosed in 2014 in San Francisco, and it took a few weeks before the Dr. discovered what was wrong with me. He had never had a case, and referred me to a rheumatologist who also knew very little about it. I told him of this blog and printed out for my GP papers that I had read on it. They advised me to follow the advice of the blog, with monthly blood work to check on progress. They were very good . After 4 1/2 years I was off the prednisone, but after a year it returned and off I went again. I now live in Salt Lake City, where we have a University Hospital and I have a fabulous Neurologist and the John Moran Eye Center, and I have a wonderful GP. My Neurologist was impressed with the blog, and told me that I could handle it well myself and that she would watch me, again with regular blood checks and visits. she has extensive knowledge of the disease.I appreciate their concern and care, and have been able to stabilize the relapse, and now am down again to 5 mg. She suggested that I stay on 1 or 2 mg for life to keep it under control, which I am very happy to do, since I am in my 80's and would like to live until 100 at least.!
My Granddaughter and husband and small children are in London for a month, oh, how I wish I were there with them.!! I will be over there this year at some point though.
Delia , I am sure Your narrative mirrors many of ours too ,where , information shared this health group has helped take many decisions which otherwise would have taken much longer to implement ! Every person here is one who cares about another and that is what makes it all so powerful !
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