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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by johnLA on November 26, 2013, at 22:30:23
hi all-
i am thinking of trialing 1 to 3mg of prednisone per day for my depression...
i suffer from chronic sinusitis. i have had 3 surgeries to remove nasal polyps.
before these surgeries the ent will put you on a 2 week run of prednisone. 1 week before the sugery, 1 week post-op. this greatly reduces the inflammation caused by the nasal polyps. i even get a bit of my sense of smell back for a month or so after. amazing.
i also had an unbelievable reduction of my depressive symptoms while on the steroids as well as great relief from my arthritis in my one remaining real hip.
i was not manic. i just had my old energy back.
there are some very serious side effects to long-term steroid use. but! i have found some studies that show a. low dose steroids may work for depression and b. doses <5mg of prednisone taken over decades do not have the issues of the drug taken long-term at higher doses (i.e. moon face, weight gain, diabetes, bone density issues, etc.)
here is the link that mentions 2 small studies about using steroids at a low dose for depression (it's pretty far down);
http://www.psychweekly.com/aspx/article/ArticleDetail.aspx?articleid=53
i'll make a 2nd post about the latest medical thoughts about long-term low dose steroid use..
Posted by johnLA on November 26, 2013, at 22:44:49
In reply to low dose steroids for depression, posted by johnLA on November 26, 2013, at 22:30:23
here is the link to long term low dose steroid use;
i mentioned my reaction to prednisone to my proc and he said i should talk to my gp. i'm thinking he wouldn't want to touch it since he knows only the 'bad' stuff one hears about prednisone.
i have gone on some sites where people are taking steroids long term. the side effects below 5mg daily seem far less than those needing higher amounts for their conditions. these people often mention 'energy' when describing how the steroid helps them. most are on it for pain.
i also plan on talking to doctors outside of psychiatry who rx prednisone regularly to get their thoughts on all this.
all i can say is the last time i went to the gym, met with friends w/enthusiasm, and felt 'well' was while i was on the prednisone...
i'll keep you all posted.
john
Posted by Phillipa on November 27, 2013, at 8:40:31
In reply to link to long-term low dose steroid use, posted by johnLA on November 26, 2013, at 22:44:49
John I noticed that all the patients in the studies tested for low cortisol levels. So that could be why. I personally have taken prednisone for two weeks for same didn't have the bad side effects but also no improvement. I do know that this med long term was responsible for my Mother's death. But I also have no idea how much she was given. It works great for say the bleeding colitis had when pregnant years ago. But I honestly don't think a doc will prescribe this for low term depression. Some it can cause psychosis in. But since we are all different I do hope you can trial it. Phillipa
Posted by Phillipa on November 27, 2013, at 8:44:10
In reply to link to long-term low dose steroid use, posted by johnLA on November 26, 2013, at 22:44:49
Developed during the 50's is what I picked up on when my Mother was prescribed them. And it looked to me that this was while waiting for the DMARD's to kick in? Phillipa
Posted by Hugh on November 27, 2013, at 12:28:08
In reply to low dose steroids for depression, posted by johnLA on November 26, 2013, at 22:30:23
John,
If you can find a doctor who believes in adrenal fatigue (most don't), you can get a prescription for low-dose steroids. Ten years ago I got a prescription for 5 mg cortisol. I had to go to a compounding pharmacy to have it filled. It didn't help me, but it's certainly worth a try.
Posted by Hugh on November 27, 2013, at 14:25:14
In reply to Re: low dose steroids for depression, posted by Hugh on November 27, 2013, at 12:28:08
Correction: 5 mg hydrocortisone
The equivalent amount of prednisone would be 1.25 mg.
Posted by ed_uk2010 on November 28, 2013, at 13:31:57
In reply to low dose steroids for depression, posted by johnLA on November 26, 2013, at 22:30:23
> hi all-
>
> i am thinking of trialing 1 to 3mg of prednisone per day for my depression...
>
> i suffer from chronic sinusitis. i have had 3 surgeries to remove nasal polyps.The thing is, long-term use does generally produced adrenal suppression, and eventually some degree of adrenal atrophy. The dose may therefore require some increase over time because your adrenal glands will not be producing as much cortisol (hydrocortisone). There's also a possibility of the initial positive psych effects turning bad.
Would it be feasible to use intermittent low-dose courses? (Osteoporosis prophylaxis is advisable if repeated courses are necessary).
Posted by ed_uk2010 on November 28, 2013, at 13:36:12
In reply to Re: low dose steroids for depression, posted by Hugh on November 27, 2013, at 12:28:08
>If you can find a doctor who believes in adrenal fatigue (most don't), you can get a prescription for low-dose steroids.
The thing is, continuous use of steroid tablets suppresses (not 'supports') adrenal function, creating physical dependence on the drug.
Long term use is essential in severe adrenal failure (Addison's disease) but should be approached with caution in other circumstances. Even in severe destructive rheumatoid arthritis, for example, it's probably best to continue low-dose tx for less than 2 years. Excessive treatment seems to reduce life expectancy :/
Posted by johnLA on December 2, 2013, at 9:39:57
In reply to low dose steroids for depression, posted by johnLA on November 26, 2013, at 22:30:23
Posted by phidippus on December 5, 2013, at 17:20:18
In reply to low dose steroids for depression, posted by johnLA on November 26, 2013, at 22:30:23
Long term side effects make the benefits seem unworthy. There are plenty of other drugs out there that can be trialed.
Eric
This is the end of the thread.
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