# Corticosteroid induced mania



## GNC Crohn's Man (Nov 8, 2006)

That is a classifaction of drug induced mania that if you have been on any high dosage of corticosteriod you have been through... Now you know the beasts name.. 

Here are the symptoms and some ways of dealing with it... 

That's for those of you that can read medical jargen...

Mania Detailed Medical Jargen
http://www.biopsychiatry.com/maniadrug.htm

Mania Detailed Medical Jargen
http://www.biopsychiatry.com/corticosteroid.htm

For the learned indvidual that has trouble with medical jargen...

Mania Less Medical Jargen
http://www.bipolarhome.org/mania.html


This is about as simple as it's going to get...


What Is Bipolar Disorder?
http://www.webmd.com/content/article/102/106771.htm

Hypomania and Mania Symptoms
http://www.webmd.com/content/article/102/106777.htm

Depression Symptoms
http://www.webmd.com/content/article/102/106778.htm

Talking to Your Friends and Family About Bipolar Disorder
http://www.webmd.com/content/article/102/106779.htm

Mood Swings and Bipolar Disorder
http://www.webmd.com/content/article/102/106804.htm

Bipolar Disorder and Going to Work
http://www.webmd.com/content/article/102/106801.htm

Living a Healthy Life With Bipolar Disorder
http://www.webmd.com/content/article/102/106800.htm

please sticky this post....


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## Skinsfan1229 (Nov 8, 2006)

stickied!


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## Starbelly (Nov 8, 2006)

replying to a sticky? should have looked up here sooner thanks... Mania... haha


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## Skinsfan1229 (Nov 8, 2006)

lol its ok, its meant to be replied to...I just replied sitckied so that he would know, AND to bump the thread to the top so its more clear to recogize

How common is this mania? and What are the odds or percentage? Does it go up with pro-longed use? or does the risk go down because your body is used to it?


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## GNC Crohn's Man (Nov 8, 2006)

The higher the dosage and the more prolonged the use the more likely you are to have a manic episode... More than likely you have already had one and didn't even know it if you were on a high dosage of corticosteriods for any lenghty period of time... Lower dosages generally mean much less chance of mania and also certain people are more predisposed to devoloping mania than others... It all depends on your overall mental health, willpower, physcial health (when you get sick its much harder to control your emotional state since a lot of your mental resources are being used to try to keep your condition stable), and what other medications you are currently on... All of these things are involved when dealing with mania.. Even I go through manic episodes but I've been on a very high dosage for a long time... 

Btw I'm finnaly down to 35 mg of prednisone a day taken as 20 then 15... 

I think I answered your question if not then ask another LOL...


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## Jeff D. (Nov 8, 2006)

I had that but was never diagnosed.  I just would go insane every so often.  All hell would brake loose.LOL


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## Starbelly (Nov 9, 2006)

nuts right now guys! If you couldn't already tell. Just need to make it til after the holidays though... then no more drugs!


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## Cara Fusinato (Nov 9, 2006)

And then there's me . . . 6 days on Enticort and I was seeing red wanting to kill people.  You all laughed at me then, but after this thread, maybe I'm just the sensitive type . . .  :banana:   Wish I COULD eat a banana . . . anyway!


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## lizziecee (Feb 21, 2007)

*Steroid induced psychosis*

I was on steroids for some 35 years - got Crohn's when I was 25 yrs, now 62.
In those days they only had prednisolone, and I was on 60 mg a day!!
Never had any kind of problem with psychosis or sleeping. Then I was dx with breast cancer in Jan 2003 - wow it hit me like a ton of bricks as I was still on steroids. Could only sleep 3 hours in 24.  Tried to kill my husband with a knife, had to get the police, threatened to throw myself off our 5th floor balcony into Plymouth Sound outside our apartment., a nightmare.  I knew I had problems, but nobody would help - not the BC surgeon, the Gastro nor my local GP
.  I even rang the pscychiatric unit at the hospital where I am treated for bc and Crohn's and they told me to ring the Social Services! Luckily, I found some inner strength to get through it. My gastro will not now, under any circumstances, prescribe steroids. I am stable on weekly injections of methotrexate and my cancer is in remission. 
Wish someone had told me about this condition without having to figure it out for myself and nearly losing my marriage. Hope we can spread the word.
Liz.


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## Evagation (Apr 23, 2007)

I simply want to say that mania is only one of the symptoms of corticosteroid-related psychosis. You mentioned both bi-polar (not the same as mania) and depression (opposite of mania). I think it's important to note that some people experience depressive/suicidal tendencies while on Prednisone that have nothing to do with mania/bi-polar.

Personally, I experienced incredible depression and entertained thoughts of suicide while on Prednisone. Not once (and I've taken a whole lot of Prednisone since I was diagnosed at 8) did my corticosteroid psychosis exhibit as mania. 

Plus--even if you do exhibit symptoms of bi-polar, or plain mania, or plain depression, while on Prednisone, it does NOT mean that you are going to be mentally ill for the rest of your life. Exhibiting corticosteroid psychosis is a well-known side-effect and, for most people, when they have been off the drug for a few months, the psychosis goes away. 

While on Prednisone, I had to take some major SSRI's (selective serotonin reuptake inhibitors) just to combat the incredible depression. Once I had been off the drug for a month, my GI weaned me off the SSRI and the depression never returned. 

And, I hope this doesn't sound offensive but, well, I was personally offended by the advice that all it might take is some will power to keep away the psychosis. When I'm not on high dosages of Prednisone (at the highest, I was taking 80 mg a day), then yes, my will power is certainly enough to keep me sane. But on 80mg of Prednisone a day? No amount of will power in the world could have kept me sane.  That's pretty much the reason they refer to it as corticosteroid-induced psychosis. You are no longer able to control the thoughts in your mind, how you feel, and how you act. Even when I was uncontrollably crying over something truly inane, I could hear my sane self in my head telling me that, okay, calm down, you're acting CRAZY but knowing that you are psychotic, and being able to simply tell yourself to stop is impossible. I knew I was crazy, I wanted to stop being crazy... but that was the thing, I couldn't make it stop. Otherwise I wouldn't have been psychotic.

Thankfully, I had the courage to tell somebody what was going on, and to talk to my doctor about it, who was able to quickly get me on mood regulating drugs that definitely helped reign in the psychosis. I was still a bit crazy but I was no longer fantasizing about killing myself. There's nothing wrong with saying that the mood swings/psychosis is simply too much for you to handle on your own, and to ask for help. 

(Edited Later to Add: The reason I get so upset about the idea that will power can keep a person sane is that it not only isolates a person who needs more help  but it makes them feel ashamed for needing that help. Shame is such a strong factor when someone is dealing with a mental illness--medicine induced, or not--and many people don't seek the proper treatment for their problem because  they are so ashamed that they can't simply will themselves into being sane. I've lost friends to suicide for this very reason--their friends, or family, was telling them to just get over it, and MAKE themselves happy when mental illness has nothing to do with a person's will power. Even though so many people claim that it does, and all that does is make a sick person feel even worse because they believe they are weak-willed, and that they should be able to deal with their problems on their own. If will-power is enough to keep a person sane then that's GREAT, but it also means that you were never insane to begin with. The denotative definition of insane makes it clear that insanity is something that a person cannot control on their own. Cognitive behavioral therapy is a great term to substitute for the phrase "will-power." Since the goal of cognitive behavioral therapy is to give a moderately mentally ill person control over their illness. Sometimes medication is involved, and sometimes it isn't. And yes, I've been through a lot of therapy in my life and, when I'm not on 80mg of Prednisone, the cognitive behavioral therapy that I've gone through has definitely helped me bolster my sanity during stressful/depressing times)

Katie.


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## lizziecee (Jun 15, 2007)

Hi Katie - haven't been on this forum for ages - just dipped in today to see what is going on the US with Crohn's. I thought your response viz a viz steroid induced psychosis was absolutely brilliant.  I found it terrifying, and exactly as you described, "knowing you are acting crazy, but unable to stop it".  My GP eventually prescribed a drug, can't remember the name unfortunately, but when I looked at the leaflet, it said it could induce psychosis, so I threw the tablets down the loo. Luckily haven't needed prednisolone since then, but was on a daily small dose of dexamethasone during my 4 months of FEC chemo for breast cancer, which to some degree ameliorated the diarrhoea. Had to live on hospital prescribed Frutijuice (9 flavours, all yucky), but they kept me alive. 
Hope you are doing well these days.
Liz.


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## kenny (Sep 29, 2009)

man!

Well my gf of 15 years has been on me a few times about seeking testing for bi-polar. I did have a spot of Prednizone treatment 10 years ago for a sever asthma attack. I threw a hair brush right *through* the top of a cheep laminate coffee table. I also threw a porkchop right through the front of my fish tank because my GF said she was not quite hungry and wold prefer I made dinner in about an hour. I think those might have been mania when I was on the pred. 

After the fish tank issue I tossed the pred down the toilet.

Now that my surgery is coming for crohn's and Prednizone is the expected treatment I think I better have some heart to heart with the GI about this. Thanks for this sticky guys. It is probably a pretty important one.


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## Zalanicht (Jun 20, 2010)

I only had a few of those symptoms when I was on Prednisone for 2 months.


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## Barbie (Jun 20, 2010)

I threw lots of things while my mum and sisters were desperatley avoiding the flying objects, unfortunatley I even started to self harm at one point......im sure it was cos of the the VERY long time on pred....Im okay now though was a completely different person after Id been off it a while. x


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## kenny (Jun 20, 2010)

just to add to my earlier post. I did have that heart to heart with one of the GI team. Result was no pred. There are other ways to work at this.


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## weetbixkid (Jun 28, 2010)

Thank you so much for this post/thread.  I had no idea that there was a name for it.  I stopped taking corticosteriods preferring to be sick and in pain than feeling crazy.  Yet the doctors never acknowledged my side effects.  Fits of anger, uncontrollable sobbing, melancholy, and weird dream like state where things didnt seem real, sort of dejavu weirdness all while knowing, like others have mentioned that your real self is telling you, this isn't you, but being unable to 'snap' out of it or control the mental state, yet experiencing it as an observer.   

Katie, your post was excellent!

It is a relief to know that others experienced issues with this drug and that the side effects are REAL.  Even after so many years have gone by since I had prednisone, I am surprised to still find relief in knowing that I wasn't crazy!  It's validation.  

Were any of you  warned by your specialists prior to being prescribed corticosteroids that this was a possible or common side effect?  I know I wasnt.


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## Rebecca85 (Jun 29, 2010)

I wasn't warned that it could be a side effect, but then I started Pred in hospital so they were monitoring me. And I am the sort of person that actually reads those little leaflets in the box and it does have several warnings on there (at least it does on the generic prednisolone information leaflet).


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## Babs1957 (Oct 14, 2010)

Mania??? Try psychosis!!!!! Had a similar experiences to several of the above, sans police-involved drama and suicide attempts. I wasn't warned about any side effect other than it may cause me to have insomnia and hyperactivity.


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## ssv (Oct 15, 2010)

Great.  I can finally relax and stop trying to act sane. Now I have a good excuse for being crazy    The drugs made me do it :lol2:


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## MADiMarc (Oct 25, 2010)

I was on 100 mg a day at one time.  Decrease each second week by 5 mg.  It made me not sleep and gave me mood swings.  My husband learned that if I asked him to take out the trash, it meant NOW!  Not 3 seconds from now.  That was as bad as I got.  Luckily, the symptoms abated after I was reduced to 50 mg a day except for the sleeping part.  I had to take some major Rx for that.  The one good thing?  I had a REALLY clean house.  
Michele


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## Jenny06xx (Nov 10, 2010)

Wow didn't realise pred caused so many problems !


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## carrollco (Dec 5, 2010)

My mother took prednisone for back pain and was thrown into mania. I will never forget it. Scared me to death. Now I get diagnosed with Crohn's and the doc wants to put me on steriods. 

I just don't think it's an option for me.


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## Nica (Dec 5, 2010)

I am going to add in here that just because mania is a possible side effect it does not mean you will get it. It also comes in a few different levels, for some people you just get a boost of energy and feel "happy" others it can be violent then for others you may not have any mental side effects. If you haven't had a reaction to a med it may be your best option, just be aware and watch for anything out of the ordinary for you. Let your loved ones know if you are concerned to watch out for signs of it, so they can help you deal with it if it happens.

Most of the Crohn's meds can cause side effects. Some people have none, some are super sensitive. You never know till you try one if its going to work for you or not.


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## bry33 (Dec 23, 2010)

huh could it occur even years after you have been on the meds? i was  on pred for a year and a half cortosteroids for another year pred when i was 9-11 years old then cortosteroids when i was 13-14 if that is so i might want to mention this to my psycologist currently taking meds for bipolar it could have increased the risk of me developing it because my mom is mine is mostly depressive with rapid cycling where one sec i could be completly fine then ill start thinking about something then get completly depressed say the thought my boyfriend is cheating on me then ill really start to believe it then ill confront him on it and then ill say stuff that i regret then ill be back to crying and then be fine


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## Andy108 (Dec 29, 2010)

Cortisone makes me go nuts :ymad:, I simply can't use that drug.....I have had excellent results with marijuana though, if I can find a good Indica strain, it can relieve all of my symptoms, and help put a stop to flare ups.....but doctors where I live would still rather see me using horrible drugs (that don't seem to work) than use marijuana, simply because it is illegal.

Interestingly, my mother was on large doses of prednisone when she was pregnant with me, due to idiopathic thrombocytopaenia.


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## MADiMarc (Dec 30, 2010)

I was in the stuff for years and years.  I really only remember one time that I was out of control so to speak.  It was with my husband and he has since said many times that he was being a jerk and if I had actually followed through on the punch, I would have taken him down.  Now, I was on 100 mg a day and had been for a month, had not been sleeping, blah blah.  The rest of the time, I was manic I guess, but happy and very productive.

As Nica has stated, my research shows that every person reacts in their own way...big surprise.  My husband was on 10 mg for two days then decrease and he was nuts.  As he puts it, he can't hang with us professionals.

Reply to post regarding medical use of marijuana:  it is legal for Crohns in several states.  Just makes me eat stuff I shouldn't.

Wish everyone a pain free day!
Michele


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## scifi-enthusiast (Jan 2, 2011)

Last night I through my cell phone at my sister and luckily it missed her, but not the wall where it broke into pieces.


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## bethyd78 (Jan 2, 2011)

I had a major psychosis I will never I mean never take it again. I saw redddd
I yelled at everyone not just the people in my household but even people out of the house the people in grocery store at the gas station or car repair shops. I never slept I cooked all night I cleaned up constantly when my husband woke up I'd have 4 different pots on the stove. It was wild. I will never take pred again unless it is needed to save my life.
Bethy


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