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Methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol) is a synthetic glucocorticoid, primarily prescribed for its anti-inflammatory and immunosuppressive effects. [4] [5] [6] It is either used at low doses for chronic illnesses or used concomitantly at high doses during acute flares. Methylprednisolone and its derivatives can be administered ...
Large dosage variations in the patient's medication (including a self-increased dosage from 10 mg/day to as much as 100 mg/day for at least 3 months) produced extreme behavioral changes, from missed appointments to physical altercations, and eventually admission to a psychiatric ward and later to a locked Alzheimer facility.
Common side effects with short-term use include nausea, difficulty concentrating, insomnia, increased appetite, and fatigue. [5] More severe side effects include psychiatric problems, which may occur in about 5% of people. [9] Common side effects with long-term use include bone loss, weakness, yeast infections, and easy bruising. [6]
Typical mineralocorticoid side-effects are hypertension (abnormally high blood pressure), steroid induced diabetes mellitus, psychosis, poor sleep, hypokalemia (low potassium levels in the blood), hypernatremia (high sodium levels in the blood) without causing peripheral edema, metabolic alkalosis and connective tissue weakness. [5]
Common side effects may include cataracts, bone loss, easy bruising, muscle weakness, and thrush. [3] Other side effects include weight gain, swelling, high blood sugar, increased risk of infection, and psychosis. [4] [3] It is generally considered safe in pregnancy and low doses appear to be safe while the user is breastfeeding. [5]
At high doses, prescription amphetamines, used to treat ADHD could increase a person’s risk of psychosis. Image credit: visualspace/Getty Images.
If high doses were used for six to 10 days, reduce to replacement dose immediately and taper over four more days. Adrenal recovery can be assumed to occur within two to four weeks of completion of steroids. If high doses were used for 11–30 days, cut immediately to twice replacement, and then by 25% every four days.
Tachyphylaxis: The acute development of tolerance to the action of a drug after repeated doses. [15] Significant tachyphylaxis can occur by day 4 of therapy. Recovery usually occurs after 3 to 4 days' rest. This has led to therapies such as 3 days on, 4 days off; or one week on therapy, and one week off therapy. Delivery-related adverse effects