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steroid psychosis and hallucinations
My two year old and I both have asthma. Last week he was treated for bronchitis. In office he was given two shots (antibiotic and steroid). I'm not sure what steroid because my husband took him to the doctor. At home, he is taking prednisolone twice a day and breathing treatments every four hours as needed.
The night of the doctors appointment I was home alone with him because my husband was working. I thought my toddler was possessed! I've taken care of him several times while on high doses of steroids, but this was different.
He was hallucinating. He literally ran and threw himself around the house for 6 hours nonstop. He was screaming no no no! He would reach for things that were not there. He would then act like something was attacking him. During this whole ordeal, he would not let me anywhere near him.
The next day, all was fine. We continued the prednisolone and breathing treatments. Everything remained normal, just cranky.
He went back to his doc to be rechecked and his doc said it was steroid psychosis and he was hallucinating. He also said that he was making a note on his chart that he was never to have that shot again.
My questions are:
1. Has anyone else ever experienced this?
2. Are there any potential permanent side effects?
3. Obviously with asthma, he will eventually need another steroid injection. Is it likely he will have the same reaction with another kind of injection. A lower dose is out of the question. His doc said he can never have it again.
Sorry if this is long. It really scared me. Thanks in advance.
The night of the doctors appointment I was home alone with him because my husband was working. I thought my toddler was possessed! I've taken care of him several times while on high doses of steroids, but this was different.
He was hallucinating. He literally ran and threw himself around the house for 6 hours nonstop. He was screaming no no no! He would reach for things that were not there. He would then act like something was attacking him. During this whole ordeal, he would not let me anywhere near him.
The next day, all was fine. We continued the prednisolone and breathing treatments. Everything remained normal, just cranky.
He went back to his doc to be rechecked and his doc said it was steroid psychosis and he was hallucinating. He also said that he was making a note on his chart that he was never to have that shot again.
My questions are:
1. Has anyone else ever experienced this?
2. Are there any potential permanent side effects?
3. Obviously with asthma, he will eventually need another steroid injection. Is it likely he will have the same reaction with another kind of injection. A lower dose is out of the question. His doc said he can never have it again.
Sorry if this is long. It really scared me. Thanks in advance.
I was told by my doctor just today that I experienced Steroid Psychosis just before Christmas. I'm not sure what type of steroid it was and my reaction wasn't as severe as your son's. I woke up confused and asked my husband where "our" mother was and insisted he had done something to her. She does not and has never lived with us and, no, my husband and I do not have the same mother. :) As you can imagine he was very concerned. I also thought our Christmas tree was going to hurt me. I had the rationality to know what I was seeing was not real, but I can imagine your son, being so young, was very scared at what he thought he was seeing. I also had insomnia, but I get that with every steroid shot.
Incidentally the paranoia is because the prednisone (or steroid) depresses the immune system.
The "lizard-brain", which is hard-wired to protect the individual, reacts by over-emphasizing potential threats. That is why there are often inappropriate verbal outbursts.
The "lizard-brain", which is hard-wired to protect the individual, reacts by over-emphasizing potential threats. That is why there are often inappropriate verbal outbursts.
Dexamethasone has been around for a long, long time, and despite the list of side effects noted in the PDR it is a relatively safe drug. Certainly in the case of a one-time injection.
You should head for the U.S. FDA website and file an adverse drug effect report. This should be done because the lot number should be identified to insure this was not a manufacturing problem. The physician should have done this, but probably did not. I'm willing to bet he never recorded the lot number on the patient form either.
The chances of long-term effects are relatively non-existant.
You should head for the U.S. FDA website and file an adverse drug effect report. This should be done because the lot number should be identified to insure this was not a manufacturing problem. The physician should have done this, but probably did not. I'm willing to bet he never recorded the lot number on the patient form either.
The chances of long-term effects are relatively non-existant.
I have a problem taking steroids. They make me paranoid and very moody. I recently took a 5 day burst of 40mg per day and on the 4th day I became paranoid. I thought the people at the Chinese restaurant poisoned my food. I've had prednisone, medrol packs and IV solumedrol and it all ends up the same...I get paranoid and soooo moody that no one wants me around. I really hate taking steroids!
I spoke to a cousin of mine who is a psychologist. She said she is currently treating two patients for steroid psychosis. One of the ladies had an allergic reaction to hair dye a few years back and received a steroid injection. She had steroid psychosis from the injection and never went back. She is now learning how to live her life with it.
Like my son, she was not on treatments over a long period of time. It was a one time reaction. Apparently it is rare. I'm terrified of it happening to my son again. I know he will not be given decadron again, but other injections will be used later when needed.
Like my son, she was not on treatments over a long period of time. It was a one time reaction. Apparently it is rare. I'm terrified of it happening to my son again. I know he will not be given decadron again, but other injections will be used later when needed.
Here are the side effects of that steroid:
If dexamethasone is given orally or by injection (parenteral) over a period of more than a few days, side-effects common to systemic glucocorticoids may occur. These may include:
Stomach upset, increased sensitivity to stomach acid to the point of ulceration of esophagus, stomach, and duodenum
Increased appetite leading to significant weight gain
A latent diabetes mellitus often becomes manifest. Glucose intolerance is worsened in patients with preexisting diabetes.
Immunsuppressant action, particularly if given together with other immunosuppressants such as cyclosporine. Bacterial, viral, and fungal disease may progress more easily and can become life-threatening. Fever as a warning symptom is often suppressed.
Psychiatric disturbances, including personality changes, irritability, euphoria, mania
Osteoporosis under long term treatment, pathologic fractures (e.g., hip)
Muscle atrophy, negative protein balance (catabolism)
Elevated liver enzymes, fatty liver degeneration (usually reversible)
Cushingoid (syndrome resembling hyperactive adrenal cortex with increase in adiposity, hypertension, bone demineralization, etc.)
Depression of the adrenal gland is usually seen, if more than 1.5 mg daily are given for more than three weeks to a month.
Hypertension, fluid and sodium retention, edema, worsening of heart insufficiency (due to mineral corticoid activity)
Dependence with withdrawal syndrome is frequently seen.
Increased intraocular pressure, certain types of glaucoma, cataract (serious clouding of eye lenses)
Dermatologic: Acne, allergic dermatitis, dry scaly skin, ecchymoses and petechiae, erythema, impaired wound-healing, increased sweating, rash, striae, suppression of reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.
Allergic reactions (though infrequently): Anaphylactoid reaction, anaphylaxis, angioedema.
Other side-effects have been noted, and should cause concern if they are more than mild.
The short time treatment for allergic reaction, shock, and diagnostic purposes usually does not cause serious side effects.
If dexamethasone is given orally or by injection (parenteral) over a period of more than a few days, side-effects common to systemic glucocorticoids may occur. These may include:
Stomach upset, increased sensitivity to stomach acid to the point of ulceration of esophagus, stomach, and duodenum
Increased appetite leading to significant weight gain
A latent diabetes mellitus often becomes manifest. Glucose intolerance is worsened in patients with preexisting diabetes.
Immunsuppressant action, particularly if given together with other immunosuppressants such as cyclosporine. Bacterial, viral, and fungal disease may progress more easily and can become life-threatening. Fever as a warning symptom is often suppressed.
Psychiatric disturbances, including personality changes, irritability, euphoria, mania
Osteoporosis under long term treatment, pathologic fractures (e.g., hip)
Muscle atrophy, negative protein balance (catabolism)
Elevated liver enzymes, fatty liver degeneration (usually reversible)
Cushingoid (syndrome resembling hyperactive adrenal cortex with increase in adiposity, hypertension, bone demineralization, etc.)
Depression of the adrenal gland is usually seen, if more than 1.5 mg daily are given for more than three weeks to a month.
Hypertension, fluid and sodium retention, edema, worsening of heart insufficiency (due to mineral corticoid activity)
Dependence with withdrawal syndrome is frequently seen.
Increased intraocular pressure, certain types of glaucoma, cataract (serious clouding of eye lenses)
Dermatologic: Acne, allergic dermatitis, dry scaly skin, ecchymoses and petechiae, erythema, impaired wound-healing, increased sweating, rash, striae, suppression of reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.
Allergic reactions (though infrequently): Anaphylactoid reaction, anaphylaxis, angioedema.
Other side-effects have been noted, and should cause concern if they are more than mild.
The short time treatment for allergic reaction, shock, and diagnostic purposes usually does not cause serious side effects.
I am so sorry for you. Mine has never had a steroid shot but I did see reactions on albuterol (he was so angry, irritable) when he was under 1 years old.
Last night I tried SIngulair since his pulmicort is no longer working as a stand alone drug and he was up crying and saying "ear ear" from 3am to 8:30am. So I do believe you. Singulair also said hallucinations, etc.
I hate that any kid has to put up with this. I'm sad for you since all of this is very scary. Are you seeing a specialist or just a ped?
Just giving you my empathy and support. This road is scary.
Last night I tried SIngulair since his pulmicort is no longer working as a stand alone drug and he was up crying and saying "ear ear" from 3am to 8:30am. So I do believe you. Singulair also said hallucinations, etc.
I hate that any kid has to put up with this. I'm sad for you since all of this is very scary. Are you seeing a specialist or just a ped?
Just giving you my empathy and support. This road is scary.
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