the madness of PMR?: Side effects of Prednisolone... - PMRGCAuk

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the madness of PMR?

ignatz profile image
14 Replies

Side effects of Prednisolone overdosing?

I had an idea that one may become a bit loopy if taking too much Pred but can no longer find any reference.

"Symptoms of corticosteroid overdose can include: Altered mental status with agitation (psychosis)" medlineplus.gov/ency/articl...

but "Psychosis is when people lose some contact with reality. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions)." nhs.uk/mental-health/condit...

Is being happy and cheerful much of the time when taking around double Pred than needed a form of mild psychosis? Is 100% over needed an overdose?

My assumption is that I need around 10mg/daily; I did get up as high as 20mg/d a year ago to control then-current symptoms; living without pain or fog after years of pain and fog is a very good reason to be happy; too low a dose leading to pain and fog is miserable.

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ignatz
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14 Replies
MrsNails profile image
MrsNails

Have you ever met anyone who is Psychotic?….I worked in Psychiatry & believe me l have, more than once. There are people who are impacted gravely by Steroids & l would need to look that up.

But feeling brighter, better & happier on Prednisolone is very different to Psychosis.

I’ve had experience of being on 30mg Pred for a Short Time & believe me l was so OTT l even drove myself up the wall but that paled into insignificance compared to the effects of Dexamethasone on top of Pred but it wasn’t in the same realm as Psychosis.

Is thus something you are concerned about?

Kind Regards

MrsN

ignatz profile image
ignatz in reply toMrsNails

Many thanks, Mrs Nails. Yes, I am concerned as I am involved in making financial investment decisions. I am concerned I have made bad decisions/ given bad advice whilst in the 'OTT' state.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply toignatz

I think judgement can certain be affected on high doses…..and if you feel that yours is impaired, perhaps you should, if you can, take a step backward.

As we live in such litigious times, it might be wise not to put yourself in difficult situation.

ignatz profile image
ignatz in reply toDorsetLady

Exactly my thinking- and as I have been doing. :) (but I do feel like a slacker). :(

MrsNails profile image
MrsNails

As l said to ignatz l’d have to look the figures up as l didn’t know them, with not being Ward Based - what do/did they Class as High Dose Steroids?

ignatz profile image
ignatz in reply toMrsNails

See DorsetLadyPMRGCAuk volunteer at healthunlocked.com/pmrgcauk... Rheumatologist may think anything over 5mg is High- but as I only see her every 3-6 months for around 10-15 appointments, I have rather lost track. My definite impression is that she thinks 10mg/d Pred long term is far too high (although I suspect it is what I need)

MrsNails profile image
MrsNails in reply toignatz

I know what is High; Medium & Low Dose in relation to Steroids for PMR but as you know it’s a different ball game for people with GCA who generally start at 60mg often with 100mg IV to start with. Asthmatics can be on 60mg for a long time - what l the as referring to in my reply to DadCue was what was his experience of patients developing Psychosis at what kind of dose?

HeronNS profile image
HeronNS

When I first was on pred, 15 mg, I was so happy I wasn't in pain. I could do all sorts of things that I'd had to stop doing (in retrospect perhaps I shouldn't have been so happy, they included mostly things like lawn mowing and vacuuming!). However I did get excused jury duty by claiming that pred would affect my judgement. I also feared I would fall asleep during proceedings although I don't think I mentioned that! My hubby said I was like the Energizer bunny, but he was seeing me rebound from over a year of increasing pain and disability. I don't think the reaction was ott.

On the other hand when I had to increase my longstanding minute dose to as high as 10 earlier this year I was very aware of feeling different and would say I had brain fog. I did not, sadly perhaps, feel that boost of energy which in 2015 brought me closer to my wonted normal. Of course I was also this year just emerging from my knee injuries, as well as being six years older.

ignatz profile image
ignatz in reply toHeronNS

'Energizer bunny'- exactly how I felt last Summer on random 15-10mg/d Pred. Great fun.🐇

HeronNS profile image
HeronNS in reply toignatz

I didn't perceive myself that way. However because of fear of osteoporosis I got a pedometer and started measuring longer walks and in those days could actually walk 10,000 in a single go. But I was younger, had not had the effects of years of pred, and was apart from PMR much fitter then. I do not remember doing anything irrational, or certainly no more than would have been my pre-pred self!

ignatz profile image
ignatz

Many thanks, Dad2. "the OTT feeling would be considered a mental status change. It may not require hospitalization but it can be harmful." Can you say any more about the 'harmful' of OTT? I have definitely had ' mental status change' by becoming a happy bunny after months of fog and pain, but never saw or heard any non-existent rabbits.

ignatz profile image
ignatz

Thank you for that link, Dad2. Yikes! Balled mice! (see my other posting from yesterday?). I suspect I get a bit manic on 15-20mg from comments by others. So probably a relatively mild 'mental status change' but dangerous when handling funds.

ignatz profile image
ignatz

Fortunately I am a Scot so immunised against such bizarre behaviour. ;)

HeronNS profile image
HeronNS in reply toignatz

I believe even my 25% Scot has been effective!

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