Q: Connection Between BP & Prednisone
Dr., Thank you for the time you sacrifice from your life to help others. I am
just writing to comment on the Prednisone/BP connection. I was first introduced
to Prednisone in the early 1980's for severe asthma and allergies. This drug was
prescribed for me numerous times throughout my childhood and adolesence. Prior
to taking Prednisone, I had no mental health issues. While taking the drug, I
became extremely nervous, developed a tic syndrome, felt enraged at times and
became violent. It was again prescribed for me several times for a mysterious
rash, which I now believe came from the drug itself. The bottom line is that of
course I have swore off Prednisone, but now in adulthood, I have been diagnosed
with BP1, Tic Syndrome, and OCD. Maybe coincidence but I wouldn't want anyone
else to take the chance. I went from being the best in my business and well
reknoned to now barely being able to hold onto my job. Perhaps this may help
someone else make a decision or may be add to your own research.
Dear Kevin --
Thanks for your note. Other readers who are not familiar with the connection
between prednisone -- a steroid medication used to treat inflammation conditions
-- and bipolar disorder may be interested in my webpage and three, "are steroids
The connection is clear. But what Kevin describes, the possibility of bipolar
disorder precipitated by the use of prednisone, is not clear. Unfortunately,
making a causal connection between the two is difficult. You used the prednisone
through adolescence. The typical age of onset of bipolar disorder is during
adolescence. Even though you did not have symptoms before starting the
medication, and have been continuing after using the medication, we cannot be
sure that you would not have developed bipolar disorder during adolescence
regardless of taking or not taking prednisone.
We have the same challenge trying to determine whether antidepressants can
"cause" a person to have bipolar disorder who might not otherwise have had it.
You can read some examples which I think are strongly suggestive, similar to
your experience with prednisone, on my page about antidepressant controversies,
and the "kindling" concept.
It would be useful to know how many people take prednisone and do not develop
anything that looks like bipolar disorder. On that webpage of mine about
steroids, you'll note that the figure we have for this right now appears to be
about 98 % of all those who take prednisone -- in other words, of all those
starting this medication, only about 2% develop psychiatric symptoms while
taking it (we do not have information about what happens to them later) (the
figure was higher when high-dose steroids were used).
However, your experience does demonstrate that for people with a family history
of the problems suggestive of bipolar disorder, taking prednisone carries a
risk. If it can possibly be avoided, that is probably wise for such individuals.
On the other hand, this medication is generally used when symptoms are quite
severe and few alternatives are available. Nevertheless, using it for a mild to
moderate case of poison oak may not be worth it if you know that you have a mood
risk based on your family history, or your personal experience.
Thank you for using your experience to try to help
Published December, 2007