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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Waterlily on October 22, 2004, at 20:49:08
My 12 year old has been on antidepressants for a few years and she has a history of panic attacks. She was recently diagnosed with severe Crohn's disease and needs to be put into remission. I have been pretty much dead set against using prednisone for this purpose due to the side effects. I don't think she would be able to tolerate the psychological effects it might have on her. Instead, I'm going to have her on a strictly formula (liquid) diet for 6 weeks to induce remission. I'm second-guessing myself constantly though...medication would be so much easier than messing with tube feeding or getting her to drink 2 quarts of formula per day. Would prednisone really be as bad as I imagine?
Posted by Stressee on October 22, 2004, at 23:56:23
In reply to Wondering about prednisone and depression, posted by Waterlily on October 22, 2004, at 20:49:08
I just happened to read your posts and can offer you a little information. My husband had Ulcerative Colitis many years ago. The doc. thought at first it was Chron's disease and started treating him for that. He was on Azaulfadine? (spelling) and predisone with a very strict diet. He didn't gain the bloatedness or weight like some do, he lost because of the strict diet he had to follow. Now...if I remember the medication, and I don't know for sure wich one, made him act very strangely. I had to walk on eggshells around him, and it was hard because we were engaged and about to be married in a few months. He went through a phase where he thought he wanted to call off the wedding. (we have been married 18 yrs.now) It freaked me out!! He said he felt like he was outside of his body, looking at himself. Yea. Luckily, things got better and he got off the meds. He has had a coupld of smaller flare-ups, but nothing quite like that. I don't know what to tell you, maybe this information will help along with some research. Keep looking. Maybe get another opinion. If she gets depressed an SSRI may help, and I wouldn't be afraid of asking the doc. for one of those. My daughter takes one for depression and binge eating disorder, and she is fine. Some do make you gain weight, just ask the doc. Good luck, things will be OK, it's a little scary going into unknown territory. This board is really a sanity saver for me, and many others. I'm lucky I found it a month ago. Let us know she is doing, OK? -L
Posted by Waterlily on October 23, 2004, at 11:31:11
In reply to Re: Wondering about prednisone and depression » Waterlily, posted by Stressee on October 22, 2004, at 23:56:23
Thanks for the info. Sarah definitely has Crohn's. I looked at the biopsies myself and talked to two of the pathologists. I think I need to break out the ativan!
Sarah is already on an antidepressant and has been for years. She takes Lexapro 15 mg plus she takes Concerta for ADHD. (Why does she have all the bad luck with diseases? I have a 10 year old who is perfectly healthy.) I know that mental stability is a tightwalk - with her and myself (I take Wellbutrin and Luvox). I don't want to knock her out of the stability she has now. She has growth failure and cannot really afford to lose any more weight. Her formula diet would give her 2000-2500 calories per day. She started taking Pentasa (a mucosal anti-inflammatory) and azothioprine (an immunosuppresant that takes a few months to work).
Posted by Racer on October 23, 2004, at 12:12:13
In reply to Re: Wondering about prednisone and depression, posted by Waterlily on October 23, 2004, at 11:31:11
Interestingly, some steroids have been investigated as "boosters" for some patients with major depression. Dexamethasone is the drug most often cited, used briefly at a lowish dose, to jump start the anti-depressant response while titrating up on antidepressant medication. Steroidal effects tend to be long lasting, with the body not returning to baseline for up to one year.
That said, if your daughter can tolerate the liquid diet, I'd try that first -- just because the more meds involved, the more chance for interaction, idiopathic responses, etc. Just like any form of analysis, add a few variables, and you get a much, much more complex equation.
It does suck in a big way that your 12 year old has to go through so much. Best wishes to both of you.
Posted by Waterlily on October 23, 2004, at 15:36:35
In reply to Re: Wondering about prednisone and depression » Waterlily, posted by Racer on October 23, 2004, at 12:12:13
Thanks. We're looking at 40 mg of prednisone for a 71 pound child for 3 months. I don't think that's low or for a short period of time, but that's what it takes to induce remission before the azothioprine kicks in to keep her in remission. Tube/formula feeding has an equal success rate in inducing remission...it just takes a lot more discipline.
Posted by boomarang on October 23, 2004, at 18:04:33
In reply to Re: Wondering about prednisone and depression, posted by Waterlily on October 23, 2004, at 15:36:35
my mother went on prednisone a few years back and turned into a ferocious being. She became paranoid. She became mean. She said things she would never have said normally. She did things she would never have done normally. To this day she does not believe me when i tell her how horrible she was on that stuff. She also ate her way thru several towns.
of course, everyone reacts differently but if there are options, like the diet, i would try that first.
This is the end of the thread.
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