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Prednisone Side Effects Can Be Disastrous

Many doctors like to prescribe prednisone. It's a quick fix for lots of inflammatory conditions. But prednisone side effects can be bad news!

Prednisone is one of the most prescribed drugs in the country. The last time I checked, more than 10 million people filled at least one prescription for this corticosteroid. Some people take it every day. Sometimes prescribers may forget to warn patients that prednisone side effects can be challenging. This mother describes what happened to her son:

Prednisone Side Effects Can Cause Insomnia:

Q. My son was given prednisone for a sinus infection at a walk-in clinic. After only one dose, he had a horrible reaction—racing heartbeat, anxiety and sleeplessness.

After an entire week, he still struggles to get even 4 hours of sleep. The other symptoms are dissipating, but the insomnia is still a problem. The worst thing is that the doctor didn’t bother to tell him about such side effects.

A. Corticosteroids like prednisone are notorious for interfering with sleep. Doctors don’t always mention insomnia as a side effect of medications. Scores of other drugs, from albuterol for asthma to ziprasidone (Geodon) for psychiatric problems, can also disturb sleep.

Our eGuide to Getting a Good Night’s Sleep lists many problematic drugs, discusses sleeping pills and offers non-drug approaches. This online resource is available under the Health eGuides tab.

Another Prednisone Rx for Sinusitis:

Q. I am in very good health except for recurrent sinus infections. Recently, my internist put me on a 12-day tapered course of prednisone.

Within days I thought I was going crazy. I became extremely agitated and irritable and the least little thing set me off. Even with sleeping pills, I didn’t sleep for three days. I couldn’t concentrate. My blood pressure soared and I became very fearful.

My doctor never warned me about any of this. Are these normal side effects of prednisone and what will I do if I have to take this drug again?

A. Prednisone and other corticosteroids (Medrol and Deltasone Dosepaks) relieve symptoms from a variety of conditions. Arthritis, asthma and severe skin reactions to poison ivy or sunburn are just some of the disorders these drugs treat.

Psychological Reactions to Prednisone:

One reader describes “black depression” after long-term prednisone:

Q. I took low-dose prednisone for a few years following immunotherapy for melanoma. I slipped into brain fog, black depression and insomnia. It never occurred to me that prednisone might be a factor.

Then I was switched from prednisone to hydrocortisone. The depression and brain fog lifted, and the insomnia lessened.

If anyone had suggested that prednisone could cause those debilitating problems, I would have asked for hydrocortisone immediately instead of spending years of my life in a dark fog wondering why I was still alive.

A. Psychiatric side effects are relatively common consequences of corticosteroid treatment (Psychiatry and Clinical Neurosciences, Oct. 2011). Symptoms may include depression, mania, anxiety, insomnia, depersonalization, paranoia and panic. Both prednisone and hydrocortisone are corticosteroids, but prednisone is about four times more potent and lasts longer in the body.

Prednisone Side Effects Can Be Worse When Doses Are High:

Many people experience severe psychological reactions to high doses of corticosteroids. Doctors even have a name for this reaction: steroid psychosis. It can manifest as anxiety, agitation, euphoria, insomnia, mood swings, personality changes, confusion, delusions, hallucinations and even serious depression. Some people may experience memory problems. Prednisone side effects can be especially problematic if you are not warned about them in advance!

Let your doctor know you are susceptible to this kind of reaction. If you ever have to take more than 40 mg of prednisone at a time, you may need medication to counteract the psychiatric side effects.

If sinusitis is caused by an infection, an antibiotic may be appropriate. Researchers are discovering that an old-fashioned, inexpensive drug such as amoxicillin may be a good choice. Here is an article for more details (Journal of the American College of Emergency Physicians Open, June 16, 2021).

Read more information and testimonials about how prednisone side effects can affect you at this link. And remember, to learn about medications that can cause insomnia, check out our eGuide to Getting a Good Night’s Sleep and our suggestions.

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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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