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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by holliadams on March 19, 2007, at 16:26:31
I've had a chronic sinus infection for about 2 months and so my dr. put me on some steroids (6 days) to help reduce swelling.
After the first day I noticed my depression seemed completely gone. The only way I can explain it is that I felt like a kid again...the best I've felt in years. I was happy, laughing, had energy...it was great! But of course the depression came back after I went off.
Has anyone else ever had this experience? Does anyone know of using steroids to treat depression?
Thanks
Posted by Declan on March 19, 2007, at 19:42:11
In reply to Steroids help depression??, posted by holliadams on March 19, 2007, at 16:26:31
Prednisone?
If it's that or anything like it I would be very careful.
It's not something I understand, but have heard the odd bad story about.
Posted by holliadams on March 23, 2007, at 11:25:15
In reply to Re: Steroids help depression?? » holliadams, posted by Declan on March 19, 2007, at 19:42:11
> Prednisone?
>
> If it's that or anything like it I would be very careful.
>
> It's not something I understand, but have heard the odd bad story about.
Yes, it is prednisone. I know it's not something you can stay on (due to side effects) but I'm wondering if anyone knows why it lifted my depression so much. I felt the best I've felt in years. It was bittersweet because it reminded me how bad I've been feeling.It's amazing to me how chemicals can change our emotions and energy!
Posted by Larry Hoover on March 23, 2007, at 11:55:24
In reply to Re: Steroids help depression??, posted by holliadams on March 23, 2007, at 11:25:15
> > Prednisone?
> >
> > If it's that or anything like it I would be very careful.
> >
> > It's not something I understand, but have heard the odd bad story about.
>
>
> Yes, it is prednisone. I know it's not something you can stay on (due to side effects) but I'm wondering if anyone knows why it lifted my depression so much. I felt the best I've felt in years. It was bittersweet because it reminded me how bad I've been feeling.
>
> It's amazing to me how chemicals can change our emotions and energy!It's a well-known phenomenon. However, the acute experience of mood elevation is, so far as I can tell, almost always followed by mood and cognitive depression.
Hans Selye proposed that chronic stress can eventually lead to adrenal fatigue. The adrenals are responsible, largely, for regulating cortico-steroid levels in the blood. Prednisone mimics cortisone, more or less. Just why there is a mood elevation for some people using prednisone is still not clear, but hypothalus-pituitary-adrenal (HPA) dysregulation is common in mood disorders. Another corticosteroid, dexamethasone, used to be use to test for the relatively common HPA hyporeactivity seen in major depression.
Bottom line, though, is that messing with these hormones is playing with fire. I don't know of any therapeutic regime that uses corticosteroid therapy for depression. Adrenal glandulars used to be fairly popular, but.....playing with fire went out of fashion.
Consider the differences between acute exposure to prednisone and chronic exposure seen in the following abstracts.
Lar
J Clin Psychopharmacol. 2002 Feb;22(1):55-61.
Mood changes during prednisone bursts in outpatients with asthma.
Brown ES, Suppes T, Khan DA, Carmody TJ 3rd.
Departments of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-9070, USA. Sherwood.Brown@UTSouthwestern.eduCorticosteroids, such as prednisone and dexamethasone, are frequently prescribed medications sometimes associated with severe systemic side effects. Currently there are limited data regarding the psychiatric side effects of these medications, although mood changes and even psychoses have been reported. This study was designed to quantify psychiatric changes during brief courses of prednisone in patients with asthma. Outpatients with asthma (N = 32) receiving bursts of prednisone (>40 mg/day) were evaluated before, during, and after corticosteroid therapy by use of the Hamilton Rating Scale for Depression, the Young Mania Scale, the Brief Psychiatric Rating Scale, and the Internal State Scale. A Structured Clinical Interview for DSM-IV disorders was also conducted to examine past psychiatric history. Highly significant increases in the Young Mania Scale and Activation subscale of the Internal State Scale (both measures of mania) were observed with no increase in depression measures during the first 3 to 7 days of prednisone therapy. Mood changes were not correlated with improvement in airway obstruction, suggesting that mood elevations may not be in response to improvement in asthma symptoms. Subjects with past or current symptoms of depression had a significant decrease in depressive symptoms during prednisone therapy compared with those without depression. Some patients with posttraumatic stress disorder reported increases in depression and memories of the traumatic event during prednisone therapy. In summary, statistically significant changes in mood were observed even during brief courses of corticosteroids at modest dosages. The symptoms were primarily manic, not depressive. Persons with depression did not become more depressed during prednisone therapy, and, in fact, some showed improvement.
Ann Allergy Asthma Immunol. 2004 May;92(5):500-5.
Assessment of mood states in patients receiving long-term corticosteroid therapy and in controls with patient-rated and clinician-rated scales.
Bolanos SH, Khan DA, Hanczyc M, Bauer MS, Dhanani N, Brown ES.
Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-8849, USA.BACKGROUND: Corticosteroids have been used for many years for inflammatory diseases. Mood changes are common during short-term, high-dose, corticosteroid therapy. Virtually no data are available on the mood effects of long-term corticosteroid therapy. OBJECTIVE: To evaluate mood during corticosteroid therapy using standard clinician-rated and patient-rated measures. METHODS: Outpatients receiving prednisone therapy (7.5 mg/d for 6 months) and similar controls were enrolled. Current mood was evaluated using the Hamilton Rating Scale for Depression (HRSD), Young Mania Rating Scale (YMRS), Brief Psychiatric Rating Scale (BPRS), Internal State Scale (ISS), and a diagnostic interview. RESULTS: Twenty patients and 14 controls were enrolled in the study. Depressive symptom severity as evaluated by the HRSD and ISS depression and well-being subscales and global psychiatric symptom severity as evaluated by the BPRS and ISS perceived conflict subscale were greater in patients receiving prednisone than controls. Manic symptom severity as evaluated by the ISS activation subscale but not the YMRS was higher in patients receiving prednisone. Twelve (60%) of 20 corticosteroid-treated patients met diagnostic criteria for a lifetime prednisone-induced mood disorder. Activation subscale scores did not correlate with YMRS scores. Other ISS subscales showed expected correlations with clinician-rated assessments. CONCLUSIONS: Mood symptoms and disorders are common in corticosteroid-dependent patients. Unlike short-term prednisone therapy, long-term therapy may be more associated with depressive than manic symptoms based on the clinician-rated assessments. The ISS may be more sensitive to mood symptoms with prednisone than clinician-rated scales.
J Affect Disord. 2007 Apr;99(1-3):279-83. Epub 2006 Oct 9.
Effects of chronic prednisone therapy on mood and memory.
Brown ES, Vera E, Frol AB, Woolston DJ, Johnson B.
Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, United States.BACKGROUND: In animals, stress and corticosteroids can be associated with both reversible and irreversible changes in the hippocampus. Changes in memory and hippocampal structure, perhaps in part due to cortisol elevations, are reported in some patients with mood disorders. Minimal data are available on the effects of long-term exposure to corticosteroids on the human hippocampus. We previously reported greater depressive symptom severity, poorer memory and smaller hippocampal volumes in patients with asthma or rheumatic diseases receiving long-term prednisone therapy than in controls. METHODS: In this report, patients and controls were assessed a mean of 4 years after the first assessment to determine if depressive and manic symptoms and cognition remained stable, improved or worsened. Seven prednisone-treated patients and six controls were identified and agreed to reassessment with psychiatric symptom and neurocognitive measures. Follow-up MRIs for hippocampal volume analysis were available for two prednisone-treated participants. RESULTS: With the exception of an increase in depressive symptoms in those receiving prednisone, participants and controls did not show significant change in mood or cognition from the initial assessment. One participant discontinued prednisone and showed improvement in psychiatric symptoms and cognition. Hippocampal volumes were available in two prednisone-treated participants and showed inconsistent findings. LIMITATIONS: A limitation is the small sample size. CONCLUSIONS: Our findings, although preliminary in nature, suggest that long-term prednisone therapy is associated with initial changes in mood, memory and hippocampal volume that appear to stabilize over time.
Posted by elanor roosevelt on March 30, 2007, at 8:54:20
In reply to Re: Steroids help depression?? » holliadams, posted by Larry Hoover on March 23, 2007, at 11:55:24
i have been prescribed fairly high doses of steroids a number of times for severe respiratory infections
i look great
my hair shines
i move large pieces of furniture around.
the firat time i asked my doctor what would happen if i kept up he dosage long-term
he told me i would eventually puff up and diesteroids are a nightmare when you stop taking them and i have had several bad bouts getting back on track after plunging into depression
last time i just stopped my ADs knowing i would have to start a new routine once i was off the steroids
Posted by notfred on April 7, 2007, at 15:42:55
In reply to steroids: a fleeting respite, posted by elanor roosevelt on March 30, 2007, at 8:54:20
I have taken a lot of cortisone like drugs. Loss of bone and increased risk of seizures are 2 effects
I got from long term use.
Posted by holliadams on April 8, 2007, at 20:31:56
In reply to steroids: a fleeting respite, posted by elanor roosevelt on March 30, 2007, at 8:54:20
Thanks for the feedback and info guys.
Yeah, I did get some bad side effects. Toward the end of my treatment on the steroids I got a really stiff neck, double-vision, and severe swelling in my hands. Plus, I wasn't able to sleep at ALL for about 2 weeks. I was popping benedryl at night to help and would just lay there staring at the ceiling until morning. It was awful.
When I did finish them, my depression got pretty bad for a week or so.
I think they are all out of my system now and I definitely see why they are NOT good for you. They helped with my sinus problems but it was only temporary.
Thanks for taking the time to respond though.
This is the end of the thread.
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