Prednisone - depression better or worse - on or off it?

[ami42]

Hi Everyone, I've been on Prednisone for about 6 months now since being in the hospital. I've been able to convince my doctor to taper things down (he didn't want to) the last few weeks. But, I'm still at 35mg per day (taken in the early am) which is better than the 65mg we started at. But, lately I just seem to be more depressed - I do not know if the taper is affecting this or if it's just the general circumstances.

General circumstances: I'm frustrated with being so sick & in pain/ache without improvement after so many months. And I've been struggling with my old insurance company on claims which has been very frustrating & scary. But, I'm now at my highest weight in about 5 years and I was already 40lbs overweight before this all started. Now I've added another 25lbs. But, I cannot stop eating - mostly in the mornings & afternoons - the first thing I want to do when I wake is eat - it's all I think about during the day. I feel like a ravenous out of control - wildebeast. I often wake up at night unable to sleep & want something sweet to eat. Never in my life have I done that. I look in the mirror and I do not know the Prednisone moon-face that stares back. And honestly I'm not a complainer - I just don't know where my meds are affecting this hunger & general malaise. But, do know that I feel completely blessed for all the blessings I have - especially a wonderful & supportive husband that I thank God for every day. I just need you're insight - so many of you have suffered far longer than I have - what are your thoughts?

So after that lengthy paragraph my question is once you taper off Prednisone do you feel more or less depressed? With the taper down should I expect to more depression & then for it to lift once through it?

Any insight into this is very appreciated.

Luv,
Ami

[lauralee77]

Ami,
It's hard to say sometimes. Usually i'm less depressed when I taper off, which I am doing right now. I was at 40 and I've tapered down to 15 mg/day, but my chest pain (pericarditis) feels like it's coming back now that i've cut back on the steroid, so this makes me depressed because i feel bad, but i don't want to be on high dosages of it again.

And i can totally relate with the moon face/weight gain. I'm really bad when no one is home and i'm cleaning out the fridge. My weakness is ice cream. I ate a whole pint of Ben & Jerry's yesterday, plus half of a chocalate bunny! It gets out of control.

I have found though that depression for me is a tendency no matter what medications i'm taking, and I know that lupus can cause depression, so maybe that's part of it. But i know that prednisone can cause depression, too. I think it all depends on the individual and the state of mind you are in. this probably doesn't help you any, but that's how i feel about it.

If you don't mind me asking, what were you on high dosages for?

[ami42]

Thanks for the quick reply. No worries on asking why on the Prednisone start - I should of stuck that in there. I started to lose my eyesight (both eyes) & what was left was very blurry. Plus I had started a major flare & was in horrible joint pain (combine w/butterfly rash & all). The eye part was optic neuritis (swollen optic nerve). Stopped the Plaquenil but, gained the Prednisone at the hospital. I was put on IV steriods and was able to start to reverse the eyesight loss & was able to start getting things more stablized. At the time they were also concerned about my having M.S. - luckily we were able to rule that out after a MRI & spinal tap. Although I'm much better than I was 6 months ago - the last couple just seemed to have stalled out for progress.

But, I hope on that chocolate bunny you ate the ears first. They are always my favorite! Thank goodness there is no ice cream here or I already would of downed it today!

Ami

[lauralee77]

Thank God you ruled out M.S.! It sounds like it's been a rough six months for you & I hope now you are heading towards a remission. It's great that you have a supportive husband, too. I've only been married for a year now, but mine is very supportive. I was diagnosed about 3 years ago when we first got engaged, so he's seen me through it all so far. I was doing really well at first, but since this past September i've been in a flare that just recently got worse and i ended up in the hospital. I'm out of work now, too. But now i'm tapering down on the steroid and trying to rest and take care of myself. I do see a therapist to deal with my depression/anxiety and that has helped me.

By the way, I actually ate the bottom half of the bunny because i had already eaten the ears the day before!

[Angel_Baby]

The prednisone kicked my depression in high gear. Take antidepressents to try to counter it but... not working to well.
Foooooooooooood, my gosh that is all I ever seem to be thinking about! always hungry all the time!
Hope you feel better soon

Tabitha

[raggedyann1]

ami,

Prednisone doesn't always cause depression. At higher doses it can cause some psychotic type behavior and other psych symptoms. I have depression because I have lupus which is a life long chronic disease.
Lupus itself can cause depression 1. organic from the disease itself and 2. situational living with a chronic disease. I can see where lowering the prednisone dose with no other medication to replace it can bring back more symptoms which would increase depression.

What other disease modifying medications are you taking? usually the goal with prednisone is to get the patient off once another medication is working to control the lupus.

Let us know how you get on.

Take care,
Karen

[ami42]

So many meds - the main ones are Prednisone, Neurontin (nerve pain), Effexor, Vicodin as needed, Lunesta & Cellcept is the drug that I'll "switch" to once fully tapered off Prednisone.

In many ways the depression is truly part of Lupus - there are good days & bad days. But at times especially in a taper down I can really notice the depession increase for those days & then even out. Most of the taper downs are filled with increase symptoms such as pain - muscle ache etc. so it's no suprise that would make you feel a bit more depressed. The weight gain from all the medications is a huge factor in everything. So many aspects. Prednisone is after all the drug we love to hate.

But, I work to keep it positive & stay as busy as possible. Hopefully changing drugs will help the overall chronic disease of Lupus.

Ami

[pauline1946]

predisone also causer extreme aggitation---i could have
killed the pope when i was on it. BUT it saved my life.

[raggedyann1]

Ami,

Are you saying you won't be starting cellcept till you have tapered off prednisone completely? That is just a different method than I am used to. My rheumy started me on disease modifying medications and then weaned me off of prednisone - his goal to prevent a flare up. Have you ever taken plaquenil? It is a standard lupus medication but does take several months to really make a noticeable difference? Many of us take plaquenil in addition to the immune suppressors like cellcept. Many of us take anti-depressants to help deal with the depression that comes with this disease.

Let us know how you get on.

Take care,
Karen

[ami42]

Hi Karen, unforuately I tried Plaquenil but, was one of the few that end up with eye issues. So although it benefited me in so many other ways I had to stop taking it. I believe she plans for me to wean off completely prior to the new drug but, I'm going to clarify with her on my next appointment. I definitely do not want to make my current flare worse if at all possible. Granted I'd do just about anything to get off the prednisone (due to the side effects). But tapering is horrible - we started doing it in 2.5 tapers & at times 5mg tapers to get from 60mg+ to 35mg per day. I missed 5mg of my 35mg daily dose yestereday. By afternoon I could barely move - it was horrible. I finally figured out what happened and took the missing dose but, it was a wee bit late and I paid for it.

I'm glad to have people like you to help me. I've was finally diagnosed with Lupus this last year & it's been a bumpy ride getting things under control. The research part is easy but, getting a person who actually has Lupus & been through it offer advice is priceless.

Thanks,
Ami

[Raglet]

higher doses of pred (40mg and upwards) make me feel anxious and jittery, but not depressed.

If I am having depression that is caused by lupus, then prednisone is a just about instant cure, and I feel back to normal within days. I also have regular depression, but that is treated by anti-d's and is quite different.

cheers

raglet