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Understanding Psychotic Reactions Linked to Prednisone

8/1/2025, 4:01:02 PMMale25-34

Greetings everyone! I’ve been observing from a distance for quite some time, but now I’m stepping up to share my situation. I’m reaching out in hopes of gaining some clarity regarding an unsettling experience that took place in October 2024. It was both confusing and distressing, and I’m eager for more information. To give you some context: for the past four years, I’ve been battling a series of relatively minor to moderate health concerns; however, those details may not be very relevant to my inquiry. Looking back to around 2016, I was given prednisone along with a course of azithromycin to treat a respiratory infection that followed shortly after recovering from sinusitis. That was my first encounter with prednisone, and initially, everything seemed fine. A fortnight after completing the prednisone regimen, I noticed that my palms and the soles of my feet had turned red and puffy. They felt unusually full, almost as if they might burst. This condition persisted for several days to about a week, leading to skin peeling from my fingertips to the tips of my toes. The peeling was excessive, prompting me to wear gloves at work to manage the flakes, as it was quite unappealing. Thankfully, my skin wasn’t raw or damaged, just excessively shedding. This peeling phase continued for approximately 6 to 8 weeks before it came to an end. My doctor at that time attributed this reaction to over-cleaning or using too many products (I always clean while wearing gloves). At that point, I had not yet connected the dots between prednisone and my symptoms, primarily because of the delay between stopping the medication and the onset of redness. The doctor, concerned, advised against further use of prednisone, highlighting the potential external consequences of internal effects. Now, fast forward to September 2024, when I found myself dealing with what turned out to be trigger thumb, which ultimately necessitated surgery in January of this year. Unfortunately, by October 2024, my condition was still worsening, prompting me to seek urgent care for relief before an upcoming vacation. My regular physician's recommended home treatments were proving ineffective. Despite my previous reactions documented in my medical records, the urgent care facility prescribed a course of prednisone. After about five days on the medication, things took a drastic turn. Twelve days post-prescription, I experienced a manic episode. Prior to this, I had never dealt with mania or significant mental health challenges, aside from occasional situational anxiety throughout my life (I’m 38 years old). This manic state led to an ambulance ride, an unfortunate situation involving law enforcement—who misjudged my condition—and ultimately a stay in an in-house psychiatric facility for 24 hours after being involuntarily admitted. Regrettably, I can’t alter this past experience, but my primary concern now revolves around the psychiatric side effects associated with prednisone. My mental clarity, which I’ve always considered my greatest asset, felt stripped away for about 21 hours. This ordeal has instilled a sense of fear and resentment toward police, and I’ve resolved never to call an ambulance again—our request for a private hospital was overridden by the officers, primarily due to their assessment of my mental state. Additionally, my lab results indicated some issues with my kidneys that day, causing further confusion about the series of events. Deep down, I have a strong belief that prednisone played a significant role in this experience. I’ve consulted with pharmacists, but their responses were generally brief and lacking detail. My primary care physician, who is nearing retirement, concurs that the prednisone likely triggered these events but has offered little beyond that. I appreciate any insights you might offer to help me make sense of this situation and find some peace of mind. Thank you for your assistance!

Bipolar DisorderOCDAnxiety

Answers (1)

Cony

8/1/2025, 4:02:04 PM

OpenHealth AI

It sounds like you’ve been through a very intense and challenging experience with prednisone, and I commend you for seeking clarity and understanding about its potential effects. Prednisone is a corticosteroid that can have various side effects, some of which can impact mental health. Let's break this down for better understanding and guidance.

Key Points:

  1. Prednisone and Mental Health: Prednisone can sometimes lead to psychiatric symptoms, including mood swings, anxiety, and even manic episodes, especially in individuals with a predisposition to mental health issues. This reaction is not common but can occur.
  2. Physical Reactions: Your physical symptoms, including skin issues post-prednisone, while distressing, might be more related to sensitivity or an allergic reaction. However, connecting them directly to prednisone requires a detailed assessment beyond anecdotal evidence.
  3. Moving Forward: Understanding these side effects and having open discussions with healthcare providers can help manage future treatments and fears.

Explanation:

  • Corticosteroid Effects: Corticosteroids like prednisone impact the body’s inflammation response, but they can also affect mood and behavior. The brain's response to prednisone can lead to feelings of euphoria (mania) or depression in some individuals.
  • Delay in Symptoms: Your experience with delayed physical symptoms after stopping prednisone can happen. It’s important to recognize that this medication can have lingering effects.

Next Steps:

  1. Document Your Experiences: Continue keeping a record of your symptoms, both physical and mental, to identify patterns and triggers. This information can be invaluable for future healthcare consultations.
  2. Communicate with Current Healthcare Providers: Given the psychiatric episode, consider discussing your past reactions to prednisone explicitly with your primary care physician or a mental health professional. They can help you assess any predisposition to mental health issues and potentially adjust your treatment plan.
  3. Explore Alternative Treatments: If you need anti-inflammatory medication again, discuss alternatives with your physician that might less likely trigger mood changes. Options might include different classes of medications or non-steroidal anti-inflammatory drugs (NSAIDs) where appropriate.
  4. Mental Health Support: It might be beneficial to speak with a mental health professional who can help you process the trauma from your experience. They can also assist in developing coping strategies for anxiety or fears that have emerged.
  5. Educate Yourself and Others: Understanding more about prednisone and its effects (you can find information from reputable sources like the CDC or Mayo Clinic) can help demystify your experiences and provide reassurance.

Your awareness and proactive approach to understanding your experiences are crucial for moving forward. It’s entirely valid to seek clarity after such distressing events. Please keep prioritizing your mental and physical health as you navigate this.

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