By Dr. Mitchell Hecht
Q: My mother was prescribed prednisone for a bout of bronchitis, but it made her go crazy. She stayed up all night watching a shopping channel, spending more than $15,000. She’s never had any mental illness in the past. Why does this sort of thing happen?
A: Like a double-edged sword, steroids like prednisone are among the best and the worst drugs available. More than 10 million prescriptions for steroids like prednisone are filled each year. Psychiatric adverse effects like your mother experienced are not as rare as you might think. Two large studies which analyzed many past studies found that severe psychiatric reactions occur in nearly 6 percent of folks, and mild to moderate reactions can occur in approximately 28 percent of folks prescribed steroids like prednisone. While some have attempted to explain these psychiatric adverse effects to a prior history of mental illness, the vast majority of those affected had no such prior history. Research suggests that the dose and duration of the steroid are much greater risk factors for a psychiatric adverse effect.