Prednisone & Bipolar Disorder
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Q:  Prednisone & Bipolar Disorder

My 33 year old son, Coby, has bipolar disorder.  Although he had been seen by many psychiatrists from 15 years of age to the present, a firm diagnosis had never been made until last year as he also has OCD.

Coby has had three psychotic episodes.  Two were related to prescribed medications (prosac & effexor) and occurred during his late teens.  His most recent episode occurred last year and was quite severe.  He visibly decompensated over a period of several weeks, became paranoid and then manic.  While in the manic phase, he attempted suicide with a pistol that malfunctioned.  He then attempted 'suicide by cop'by shooting bird shot into the ground when police came to help us with him. This resulted in our son being shot by the police (through his hand)and 5 months in the local county jail. While in jail we had Coby assessed by a forensic psychologist who readily diagnosed the bipolar disorder.  We were eventually able to get reduced bail  in order to take Coby to a well regardedPsychiatric Hospital here in Tulsa. Coby spent 11 days in the adult stabalization unit and was again diagnosed with bipolar disorder.  Since his discharge, he has been living in a residential care facilit  y and attends day treatment from 8-3 monday through friday.  He has done well there and has benefitted from mood stabalizers and group therapy.

However, Coby now faces a trial and is charged with assult with a deadly weapon which if found guilty could result in a sentence of 20 years to life in prison.

The hardest thing for us, his parents, and for those that know our son is that Coby has never been violent prior to this event. He is highly intelligent and high functioning in relationship to his mental health condiditions.  He tends to be kind and considerate and is typically the peace maker with his group of long term friends.  During Coby's two previous (when a teenager)pychotic episodes his symptoms included hearing voices, becomming highly energetic, and delusional but no violent acts.  He even became catatonic during the first episode.

So here is my question,

For three months prior to Coby's recent psychotic break, he had been stung by wasps (on three seperate occassions) and had, for the first time, had highly allergic responses resulting in trips to ER, and prednisone injections and prednisone p.o. He also had three separate occassions of being bit by brown recluse spiders and the last bite was at the base of his neck which became so swollen it appeared to be another head.  He was also treated for these bites with prednisone and antibiotics.  It was during the last few treatments that our son became notably mentally unstable.

Since that time he has been his usual self both on and off medications, although less anxious with meds.

One of his psychiatrists at Laureate Hospital felt that perhaps the prednisone had triggered Coby's psychosis.  I often wonder if it wasn't a combination of spider venom and prednisone???

In any event, although I have read similar questions on your web site I was interested in what you think.  Is there any research about prednisone and bipolar patients?  It could help us with Coby's situation if we knew more about how likely or unlikely is such a severe response to stings or prednisone.

I know this is a long letter.  Thank you so much for your consideration about our question.  This web site is a great service to families and indivduals living with bipolar disorder.  We appreciate your ongoing efforts.


Dear Ms. L' -- 
Sorry for the delay in this reply. I hope it's either still in time or that things have gone well legally for Coby. You may have seen the section of a page on my website about
prednisone and bipolar disorder.  That summarizes everything I've been able to find so far ( just did a quick search for anything new; nothing much, just this article by one of the same research groups, just showing that even low doses for a short while can have an impact on mood: Brown 2002). 

Dr. Phelps

Published February, 2007

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