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I recently was prescribed prednisone (a corticosteroid) for a nasty poison ivy rash I contracted from my garden, my dog or one of my children. I have horrible allergies and know to avoid contact with anything looking remotely like poison ivy, so the fact I got it without seeing it had me stumped.
I had never been on prednisone before, and had heard from the doctor about the side effects which include irritability, weight gain, night-sweats and low-potassium, among others. I didn’t experience any of those (thank goodness, I’m trying to lose weight, not gain weight). I experienced elevated mood and increased productivity. I wondered why prednisone isn’t prescribed for mood disorders, as I felt better on prednisone than I had felt during four months of taking Prozac® a few years ago.
The morning after I started taking prednisone, I woke up with a crazy urge to go running. I knew something was going on, because I never “feel” like going running. While on the prescription, I cleaned my whole house, did projects I had been putting off, was particularly cheery, and was ultra-productive at work.
I was curious about my reaction to prednisone, especially since I heard from friends and relatives who had experienced adverse reactions to it. They talked about the irritability, headaches, gaining weight, and having thyroid issues. I wanted to roll in poison ivy to be able to stay on this seemingly wonder drug.
It’s a steroid, but not like anabolic steroids which have received a bad name from use and abuse by body builders. Corticosteroids are drugs that are closely related to cortisol, hormones produced by the adrenal gland. Prednisone is typically prescribed for inflammatory conditions, like my acute allergy to urushiol inducing contact dermatitis, and everything from MS to lupus and cancer, and for preventing body organ transplant rejection. It works by suppressing the body’s immune response and reduces swelling and allergic-type reactions.
So in my case, the drug was prescribed to halt my allergic reaction to urushiol, the organic oil toxin found in poison ivy. I was told by the doctor at Urgent care that the blisters from the poison ivy could continue to develop for up to three weeks after initial contact and could take even longer to heal.
Since prednisone could cause a crash-type reaction when stopping the medication, the doctor prescribed on a “weaning” schedule (five pills the first two days, four pills the second two days, and so on until I took one pill for two days, then stopped), to try and limit crashing.
A friend who is a doctor told me, “It is a steroid so long term complications include bone thinning, weight gain, gastrointestinal upset, and hypercortisolism, which may lead to Cushing's syndrome. It depletes Calcium, Folic Acid, Magnesium, Potassium, Selenium, Vitamin C, Vitamin D, and Zinc.”
Long term use is not an option, and extended use (more than one course of treatment) could result in different effects. The risks drastically out-weigh the benefits for someone who is not stricken with a serious disease. So I’ll have to just stick to my exercise and healthy eating plan for long term happiness.
Christine Jeffries is a writer/editor for work and at heart, and lives in a home of testosterone with her husband and two sons. She founded a women’s group, The Wo-Hoo! Society, in the interests of good friends, networking, and philanthropy; the group meets separately on a monthly basis in Phoenix and Kansas City. Christine is interested in women’s health and promoting strong women.
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I just started taking Prednisone 20mg (2/day) for 7 days.
I had a Goiter (enlarged thyroid) and was misdiagnosed for 10 years with (chronic sinusitis) and acid re-flux.... 10 years I suffered and struggled to maintain a quality of life. I had forgotten what it was like to be normal. Today I woke up and I FELL AMAZING there are no words to describe it. I am 31 but feel like i was 18, the disease (we thing Graves) has been effecting me since my early 20's.
Stopped by here doing my research, I am sad that i can't take this for the rest of my life. I'm affraid to go back to the living hell I was trapped in. Now that I know what i have been missing.
I have so far experienced no side effects, I feel motivated, I am physically stronger, my mind is focused, my headaches and swollen thyroid are gone.
I am also on a beta blocker Propranolol which completely stabilized my heart palpitations and tachycardia caused by the hyperthyroidism.
If i only have 7 days left to live I guess im going to make the best of it, before returning to HELL.
I hope the doc can find and alternative, I want to feel this way for the rest of my life.. I fear that remember what it was like to be normal, to have energy and focus, I might get depressed if I go back to the way I was.
January 6, 2016 - 8:50amThis Comment
Fellow Anonymous user,
I have been experiencing the same exact thing you have described above. My doctor prescribed Prednisone for 14 days and those 14 days were the best I had experienced in years. Vitality, enjoying life, focused, etc. Now, sadly, I have returned to the previous HELL you described as well. There is clearly something at work here, so I would like to get to the bottom of why this drug was so impactful and why?
Hope you feel better!
February 1, 2016 - 10:52amThis Comment
I have found prednisone to be a life saver. I have had low energy problems most of my 70 years, causing family/friends to make jokes about it. I have been bedridden for days from severe stress of any kind, most recently from combination of hip replacement surgery, family issues, and neighborhood problems. I was so fatigued/depressed that I needed a Medrol 6 day pack of 10 mg tapered doses to get my power back. Have been on 5 mg per day for almost 3 years in order to function normally. For about 7 years, I crashed every time I went on a trip, being unable to get out of bed next day. My doctor back home would call in a 10 mg prescription to a local pharmacy and within mere hours I'd feel like nothing happened, then feel like I could clean a dozen houses the rest of my trip. It didn't matter whether I had traveled by plane, train, or car. Any extra demand on my energy took me down hard. I became hypothyroid many years prior, and was diagnosed with Fibromyalgia 10 years ahead of that. There are connections in these that may account for my body's inefficient cortisol production, and it's dramatic response to prednisone. My specialists tested me for autoimmune diseases that respond to prednisone. Nothing was found. I even had muscle biopsies that showed no reason for my muscle weakness, joint/muscle pain. For some reason, prednisone fixes all that and makes me feel like Wonder Woman! Thanks for all your posts. Very interesting differences!
.
September 1, 2015 - 8:21pmThis Comment
I am the person , Gainor Hillegass - Tampa, FL, who wrote this post almost 2 years ago. Three months later, we discovered why I repond so dramatically. I have adrenal insufficiency! It was diagnosed when I had the mother of all crashes from a silent UTI, which my body couldn't handle. Out of nowhere, I had sudden severe abdominal pain, diarrhea, vomiting. I though it was the lunch I ate on way home from cardiology stress test. Hours later, I could not stand or talk. My son found me semiconscious in the bathroom after work. 911 was called. As they moved me, the vomiting continued. I couldn't look up or respond to their questions. I though I had a stroke and felt like a statue, unable to communicate. I had become severely dehydrated. IV revived me. After tests and CT of abdomen, it was determined I had suffered an Addisonian Crisis, where the insufficient adrenal cortisol could not rally my body to handle the infection. I spent 6 days in the hospital on massive doses of steroids. My maintenance dose varies between 15-20 mg, depending on my level of stress or activity. I wear a Life Alert pendant, and have the GPS for when I am out and about. I have notes to EMTs in house and hanging from car mirror - in case I am unable to speak - alerting them to my need for rescue doses of cortisone. My doctors told me to go straight to ER if I ever have vomiting/diarrhea more than 3 times in a row. I will dehydrate quickly and could go into a coma.. I was almost in one when I went to the hospital. Then the body shuts down. I urge all of you to have your adrenal hormones tested. Insufficiency causes inflammation/pain, fatigue, heat and exercise intolerance, brain fog, depression - things reflecting low metabolism. Cortisol regulates everything in your body! Our adrenals make make enough to handle a normal day, but not the emergency amount necessary to get us through an infection, surgery, stressful event. We who have miraculous results with prednisone are probably deficient to start with. We feel "normal" , and supercharged when we are put on it for something. There are frequently coexisting thyroid problems. I hope you all get tested and put on low dose to correct deficits. You will certainly feel better!
July 14, 2017 - 6:42amThis Comment
I am so glad I am not alone! Until having sinus surgery I was plagued with chronic sinus infections for which my doctor would prescribe an antibiotic, along with prednisone to bring the sinus swelling down. I had attributed my elevated mood to just being happy to breathe again. Fast forward a year and half post-surgery and I found myself with an infected sinus polyp. So back I went on the meds, this time on a different antibiotic but same steroid. Since I was felt decent going into it, I could tell immediately that the steroid was the reason for my mental clarity and better mood - because literally within 2 days of finishing it (but remaining on the antibiotic) I came down ... hard. I really never gave much credence to a pill's ability to make you happier (in college I was prescribed Prozac and never felt worse in my life) but there is definitely something to this. Many thanks to the OP and the commenter who made the dopamine connection. You have opened my eyes!
July 27, 2015 - 8:11amThis Comment
I had this exact reaction when I was prescribed prednisone for two weeks to treat an asthma attack that wasn't responding to albuterol. I never even realized I was miserable, exhausted, and overwhelmed... until suddenly I wasn't.
I had energy. I was getting up to my alarm with no snoozing. I was happy. I was productive. I was dreading the end of that bottle. But the worst part? No one believed me. I tried to tell my doctor about it, and he just kept telling me that prednisone was dangerous. Of course I understood that. I didn't want to stay on the prednisone. I gained twenty pounds during those 2 weeks. I just wanted to know how it worked. Obviously, it was affecting my neurotransmitters, but which ones?
And so he explained that prednisone was dangerous. . .
And then he tried to tell me that I felt more energetic because I was getting more oxygen, and I burst into tears. . . and asked for a psych consult.
And my psychiatrist told me that prednisone was dangerous. . .
But I am persistent. If the doctors didn't know how prednisone affected a person's brain, then I would need to take a crash course in neurological / chemical psychology.
The best explanation that I have found is this...
Prednisone acts similarly to cortisol in the body. They are nearly chemically identical. Cortisol forces your liver to create trytophan oxydase. It's the chemical that metabolizes tryptophan. Tryptophan is precursor to 5-HTP which turns into serotonin. If your body is breaking down tryptophan before it is turned into serotonin, this means LESS SEROTONIN IN YOUR BRAIN.
Sounds like a bad thing, right? Well, for most people it is. Most people get moody, cranky, anxious, and depressed when they take prednisone. So, what about that small percentage of people who have the opposite reaction, and feel more ... MOTIVATED?
The answer is Dopamine. Dopamine is the 2nd feel good neurotransmitter. It's the body's internal reward system. Dopamine is your brain's way of giving you a giant gold star for doing the dishes, or exercising.
Serotonin and Dopamine have a competitive relationship, because they are both created by the same 'aromatic amino... something or other'. It's a chemical. It dissolves stuff. It's called AADC.
AADC breaks down 5-HTP to create Serotonin. AADC also breaks down L-Dopa to create Dopamine...
So, by destroying some of the tryptophan in your body, the prednisone is freeing up extra AADC. That AADC starts making extra dopamine, and suddenly, you find yourself cheerfully cleaning out your refrigerator.
Which probably means that for the people who react to prednisone in a positive way, their bodies are naturally creating too much serotonin and not enough dopamine to begin with, and the prednisone is creating a better balance.
Excess serotonin and low dopamine causes apathy, lack of motivation, procrastination, insomnia, difficulty concentrating... and other bad stuff.
It's depression's lazy jerk of a cousin... anhedonia.
Here's a website about the effects of excess serotonin production in the brain in case you are interested.
http://mindrenewal.us/page10.html
And after much research, and discussions with my psychiatrist, I was able to improve my mental state with a dopamine reuptake inhibitor.
Welbutrin is one.
January 6, 2015 - 11:55pmRitalin is a better one.
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Thank-you for your research re: serotonin. I grew up with many of the symptoms listed in the other article and was saddled with the allergies diagnosis from early childhood, but over my adult years have come to believe it more to be weak immune system. Now I will do some more research into the serotonin-dopamine connection.
July 21, 2015 - 5:39amI first had Prednisone when I developed a post surgical sinus infection. Wow! I was so happy I think I must have been annoying at work, and my skin gained a beautiful porcelain texture. But after three days of not sleeping I started to freak out so called my mother who had been on Prednisone for years for asthma (and finally got off it), who flipped when I told her the dose and told me to immediately start decreasing the dose each day. I was relieved to sleep again, but I have never forgotten the incredible feeling of happiness - I thought, 'wow, I can see why people take drugs', warning bells of course.
So, I think I will look into what natural means increase dopamine' probably that exercise I never feel like doing!
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Thank you for this post. I am dumbstruck by my identical experience of elevated mood and a spectacular two days of laser focused productivity burst which was unmistakable as a 53 year old woman on medication already for 'focus' issues. A few years ago I sought help for my life-long ADD struggles which was helped by Concerta for awhile but have noticed decreased efficacy recently and since I am at max suggested dose I was going to request a revaluation. I also have asthma (and many allergies) and recently needed to take a single 4 mg dose of prednisone once a day for two consecutive days. It was prescribed due to a prolonged asthma flare up in the 4 week aftermath of a particularly nasty flu/cold episode. First day...one prednisone and....BAM....within what seems like only 30 minutes I'm hit with a wave of unprecedented mental clarity and a burst of focused energy so profound and noticeable I was a bit freaked out. Since I was expecting only to have my lung capacity improve as per dr's reason for prescribing prednisone, I was blindsided by being transformed almost INSTANTLY into feeling and thinking like what I've always imagined 'normal' feels like.
I will investigate both Wellbutrin snd Ritalin and discuss with my doctor.
Interestingly a short time ago my hubby finally sought treatment for depression and he ended up on Wellbutrin which has relieved his depression PLUS as a bonus side effect, his 'other' undiagnosed struggles with life-long focus and motivation issues disappeared into thin air. In fact he jokes daily about what he calls his 'Wellbutrin moments' that provide him with 'straight thinking' PLUS the prolonged focus AND required motivation to follow-through and complete both mundane and creative 'fun' tasks.
In researching his claimed 'Wellbutrin' moments I did find it was approved for 'off-label' use in treating ADD. I will review Ritalin now and compare the differences/similarities for the various targeted brain chemistries and required dosing frequencies between my current Concerta, Wellbutrin and Ritalin.
I once had a diagnostic MRI of my brain when I was experiencing MS-like 'mystery symptoms' and I was told I was in the 10% of the population that has Unidentified White Objects on my brain that medical science can't explain and they aren't actively reasearching since: statistically they are only found in 10% of the population; and since the UWO's can not be directly linked to any 'specific diseases' and are believed to be residing in a 'benign state'. Hah! After reading this post confirming there are a 'minor' group of folks experiencing an 'unidentified wonderful outcome' a.k.a. UWO.....makes me wonder if my brain's UWO are actually causing an imbalance in my brain chemistry through over-production or under-absorption of the key mood brain chemistries.
I look forward to getting my 'normal' on again and relish the feeling of getting rid of all the cobwebs in the corners of my house - and my brain!
January 18, 2015 - 5:45pmThis Comment
Thank goodness for your article. I thought I was going crazy. I was prescribed Methylprednisolone tablets 4 mg for 6 days to combat a bad allergic skin rash reaction - since taking this drug I've cleaned the house like an insane mad-woman, not to mention lose about 4 lbs in less than a week and feel great. I was worried the opposite would happen but not so....now that I am down to my tapering dose, I am literally "crashing" down into "normalcy" and feeling my same old, tired self again.
November 5, 2014 - 11:31pmThis Comment
I enjoyed your article. I was prescribed a short treatment of prednisone for acute sinusitus, and it worked great. I have had terrible reactions to other steroids like methylprednisolone, causing lots of tears and crazy emotions, including the feeling of not being yourself. I found your article because I have to say, like you, I took advantage of the increased energy, and good mood that the prednisone gave me. I've heard all the horror stories about the negative side effects of prednisone and was skeptical to take it becuse of my reaction to other steroids. Any drugs that mess with your mood as a side effect, no matter how rare, it seems they really affect me. I find that I can't take full doses of many drugs due to the side effects that I'm sure to get. With prednisone I felt very clear in my thoughts and extremely motivated, and I got a lot of stuff done while on the medication. My creative side spiked through the roof and I started a couple new projects. It would be nice if all the terrible side effects weren't there as I am in my mid-40's and feeling the wrath of mood swings. I too work out and take plenty of vitamin C as well as multi-vits in order to keep my energy up. In my youth, caffeine was my drug of choice for energy and a positive mood, but in this stage in my life, I can no longer drink caffeine as it really messes with my mood and gives me so much anxiety it's just crazy. I'm still looking for a good balance to help even my moods, and give me the energy and motivation I need to keep up with my busy lifestyle. Thank you again for your article.
February 7, 2013 - 8:34amThis Comment