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Asthma Treatment with Prednisone Triggered Steroid Psychosis

Prednisone treatment for asthma led to anxiety, insomnia, disruptive behavior and delusions. Patients should be warned about such side effects.

Q. My 16-year-old grandson’s pediatrician prescribed prednisone for 5 days with a follow-up of 6 weeks of steroids for a recent asthma attack. My grandson was also given an inhaler with steroids in it to use as needed.

After the third day of the prednisone, he became psychotic. His doctor must not have expected this kind of reaction, for his teachers had not been informed that he was on meds. He was suspended from school for disrupting a teachers’ meeting. In a state of delusion, he was banging on a stranger’s door asking to get his backpack, and the police were called. The sheriff brought him home.

His friends came to his house worried because “John (not real name) was not himself and was acting strange.” We stopped the prednisone and inhaler and tried keeping him home until the medication wore off, but he still had to be watched 24/7. He was anxious and kept talking very rapidly and incoherently. He could not sleep and had to be admitted to a psychiatric hospital for adolescents.

The diagnosis was steroid psychosis. He is coming home now after seven days of hospitalization, during which he was treated with antipsychotic medication.

Our family has been traumatized by this reaction in an otherwise healthy normal child. We never heard of such a response to what we understood was a common treatment for asthma. I hope everyone will be cautious when steroids are prescribed for children with asthma.

A. Steroid psychosis, whether in children or adults, is a serious medical condition. Symptoms can range from mood swings and anxiety to insomnia, agitation, pressured talking, depression, and hallucinations (auditory or visual). High doses are more likely to trigger such a reaction, but some people are more susceptible to the psychological side effects of corticosteroids than others.

Oral prednisone is usually reserved for emergencies, when asthma cannot be controlled by other medications. Long-term use is generally discouraged. Read this article for in-depth information on prednisone side effects.

Another Approach to Asthma

For a different perspective on hard-to-treat asthma, we direct your attention to a book by David Hahn, MD, MS. His research indicates that some people with recalcitrant asthma may be harboring a persistent bacterial infection within the lungs. Long-term antibiotic treatment with azithromycin can sometimes clear asthma symptoms in such individuals.

For more information about his book, A Cure for Asthma? What Your Doctor Isn’t Telling You–and Why, check out this link. The book is published by People’s Pharmacy Press.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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