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Mood and Cognitive Changes with Prednisone

Posted , 21 users are following.

Dave-California
Dave-California

I know it’s not something we all like to think about or talk about, but I have noticed that my “head” has changed a bit during the two years of my PMR. My mood and cognitive abilities seem to have changed during corticosteroid treatment with prednisone and I’m not sure if is it just because I’m getting “older” – or is it the drugs ?

Reading all kinds of different things in papers, books, etc., it appears that the neuropsychiatric effects of corticosteroids are very complicated, unpredictable, and can be severe and identified across many aspects of mental and social disorders.

There seems to be a commonly used term - ‘steroid psychosis’, which describes a variety of specific conditions related to the results of taking corticosteroids and these include mood changes, anxiety symptoms, cognitive impairments, and behavioral changes.

During the many appointments that I have had with my doctor and rheumatologist, the ‘mention’ or review of steroid psychosis doesn’t seem to have come up at all, until I brought it up as a ‘passing’ question of interest. And the response was “so what condition of the psychosis do you have and what are you concerned about”

Wow !! How do I know – apparently it’s not the job of the rheumatologist to pick that up this topic early in the doctor/patient relationship and investigate potential issues with appropriate questioning!

So who should we go and see to find out ?

So what should we do to improve our understanding of potential and active corticosteroid-induced effects ?

What is the result of taking prednisone and how do you know if is the prednisone causing the problems or is it just “getting old”. Most of us with PMR taking prednisone are not youngsters.

Eileen has already mentioned all kinds of abnormalities of the hypothalamic–pituitary–adrenal (HPA) axis - and I understand that these HPA issues can result in mood disorders – is that a common result of taking prednisone and is it described as steroid psychosis  ?

I think that one of the best ways to know what might be happening to your “head” is to ask family members – they are the ones who would notice the mood changes – and my not be ‘chicken’ to tell you about yourself ! I know that I have indeed had some ‘mental’ cognitive changes over the last few years and a bit of mood change when PMR things are not so good and although I see and feel these impacts, others have not wanted to mention any changes they have noticed, unless it ‘bothers’ them, I guess.

And again – is this aging or prednisone ?

I know most of us don’t like discussing how our “heads” are functioning, but I would like to hear other’s thoughts on this matter.

Thanks, (reasonably sane) Dave

2 likes, 25 replies

25 Replies

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  • EileenH
    EileenH Dave-California

    Posted

    I have one friend on another forum who was put on high dose pred because of query GCA - and she went into pretty much full-blown psychosis. There is some very interesting reading online about psychosis if you can find it - and no, I can't give you links because it is stuff I read about psychosis in a totally different context, not pred.

    Flutterbie - I had the short fuse experience, I really don't suffer fools gladly anyway but with PMR it got far worse causing even my husband who is used to it to comment. One occasion I remember clearly was shortly before I had a transient global amnesia episode - total loss of longer term memory which typically lasts 6 - 8 hours before "normal service" is resumed, leaving some residual loss of memory of past events. Which don't you think sound similar to the 40 min you experienced? No-one knows what causes them and - it was said in the UK - are rare (no they aren't) but only happen once (I've had a second!). I had a CT done the second time to rule out stroke - no memory at all of it which annoys me intensely!

    My main point though is that I wasn't on pred at the time. I had 5 years of PMR and no pred - and I can relate to all the things pred is accused of as part of PMR/GCA (I have only PMR symptoms and responded well to 15mg pred but I almost certainly am sort of borderline between the two given some of the symptoms I had).

    I was 51/52 when PMR appeared on the scene - again, aging shouldn't be too much of a factor although over 50 is an older adult (sorry, but there it is). I also suffered the lack of confidence issues and they are still there for a few things though much better. I had the concentration problems - knew I had to read translations extra carefully to be sure they weren't crackers! Later I couldn't see any great difference with pred - but my memory wasn't ever as good as it used to be.

    The good news though is that it does improve - my memory is pretty much back to where it was although I know there are things I feel I should remember much better from the past. If my husband can remember then so should I given his memory! I find learning new skills far better than in much of the lat 10 years - I went through one period when any new thing on the computer had to be written down for me! Now I will explore on my own a bit without having a meltdown. What does remain is a total lack of desire to explore cooking anything fiddly - it was my hobby until PMR and its physical limitations came along. Show me a recipe with more than 4 ingredients and needing more than a bit of chopping and sauteeing and you can take it away again! If you want that, I'll go out to dinner thanks!

    • snapperblue
      snapperblue EileenH

      Posted

      I too get overwhelmed by anything with more that a few steps- or anything "fiddly," as you put it.  I don't know whether it is the prednisone, but I am definitely shying away from anything at all complicated.  

      I used to be very methodical and could go from one step to the next.  Now (if I can't avoid doing something complex), I have to make a list with separate steps and not try to do them all at once. This morning I'll read the website on filing a tax amendment; another time I'll find and review the documents; etc.  Grr. 

    • Flutterbie57
      Flutterbie57 EileenH

      Posted

      Your episode does describe my transient global amnesia period. I couldn't remember what they called it confused when Iwrote it.

      I do have 'moments' when I can tackle 'fiddly' - few and far between though.

      I'm happy to simplify life, and don't you think we all deserve to go out to dinner now instead of cooking at our ageconfused It was very frustrating/depressing at first, but I am now enjoying the lazier lifestyle.

      I sometimes think that stress helped get me in the situation I am in, so I am now looking at life through different eyes, and am avoiding

      stress of any kind if I possibly can.

  • LayneTX
    LayneTX Dave-California

    Posted

    Wow!!! Dave, what a good discussion and observation on your part. And yes, sad they don't really include it when talking about symptoms. Plus the doctors just want to give anti depressant drugs.

    i was a software engineer but took early retirement just because I hated my job. But was fairly smart. 

    As a hobby I got in to painting and jewelry making and being creative, ha...using my other side of brain... But now...can't do any of it!!!!  Could care less... My PMR pains make me feel like a failure everyday, so trying to be creative or even draw, I feel like a failure. I don't or can't concentrate to do the drawing right.  Struggle reading anything other than this forum or reading about drugs, acid reflux, thyroid, health matters. Ha.

    and with others... I love TV shows, but can't stand anything too negative...

    I don't like to be around people either, having energy to socialize is too hard.  And I dont have much to say anymore either. 

    I just want peace... My new mantra I say when I wake up is... "Just Joy" and when I can feel that inside I can easily smile and NOT feel pain at that moment.

    I've even set my digital watch timer to go off every 30 minutes and remind myself to be "just joy" and in the present moment.

     

    • EileenH
      EileenH LayneTX

      Posted

      A lady in South Wales was a very successful jewelry designer and maker until she developed GCA. It upset her greatly - but she did get back to doing it after a while. She had to do different stuff and less of it but she said it made her feel so much better to be able to do something with it.

      Another lady had never been crafty in her life - but took up card making and has raised a lot of money for charity (dogs and PMRGCA) through it.

      Both of them had both mental and physical problems and struggled but their struggles paid off. Maybe you will be back there in the not too distant future. Never say never...

    • LayneTX
      LayneTX EileenH

      Posted

      Thanks Eileen!!!

      i love to make cards, but depress myself because seems no one sends them anymore.  I used to love to send Holiday cards at Christmas time, but never hear back from people, so I've given up.

      BUT you stated great idea! Maybe I could make some to donate to charity or fund raisers! Maybe SOMEBODY would still send people cards in the physical mail! 

    • Flutterbie57
      Flutterbie57 LayneTX

      Posted

      I can't remember how old you are Layne confused, you probably have told us, but you probably won't be a spring chicken, if you were nearing retirement. You have earned a good rest, maybe earlier than you had expected, but take this as your time to relax. I hope the 'couldn't care less' periods take over from your 'feel like a failure' periods.  Take time out for yourself, destress, treat yourself and we will all live in the hope that we will all spring back to life after this PMR burns itself out.confused
  • erika59785
    erika59785 Dave-California

    Posted

    I noticed these "head changes" when I was on higher than 10 mg prednisone.  It was quite disturbing to me, and my family noticed  the change with me.

    I did mention that it is due to prednisone.....not age particularly. I feel it is getting better, and I am starting to feel more myself.

     

  • artfingers
    artfingers Dave-California

    Posted

    Very interesting Dave - I had forgotten my mood swings could be due to the pred (i am currently on 10 mg).  I teach art at the elementary level and had noticed I had a super short fuse after starting my pred (5 at first, then 10 when 5 didn't work - odd to start so low but it worked for me and my blood levels are now much improved at 10 mg). So then I got talking with one of the paraeducators who was on a rather high dose of pred (40 mg) for reaction to poison ivy.  She found herself exploding at the drop of a pin so she actually took a few days off work till they tapered down her dose (doesn't have PMR).  That is when I realized that when I was getting so impatient with bad behavior of my kiddos it was probably due to the pred.  I also get lack of concentration, but I had that before.  Glad it is raining in California, you guys need it!
  • Flutterbie57
    Flutterbie57 Dave-California

    Posted

    I talked to a friend today who did have an extreme 'head' reaction to Pred. Within 24 hours she had taken to the windows in her house with a brick, because her partner did not open the door immediatly when she knocked. It scared them both, as it was so out of character for her. She was changed to another similar drug and had no further reaction. I guess we should be aware, that it can cause major changes in moods
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