Topic: steroids and depression

I can't find much in a Pubmed search (but I may be using the wrong search terms.) I'm not a chemo expert - I'm a hospital pharmacist who works the graveyard shift (they don't normally do chemotherapy on the graveyard shift.)

Blood levels do NOT necessarily correspond to action, particularly in the brain, but there are other steroids that remain in your bloodstream for a shorter period of time (such as hydrocortisone sodium succinate.)  

I would imagine other 'desirable' actions of steroids (for the person who doesn't have mental health issues - I have mental health issues too, so I'm not trying to be judgemental) - are helping to prevent nausea, helping to guard against potential allergy, and having more energy.

Since they do have other meds for nausea,  I'd certainly talk about your concern to your onc.  If you want to help prevent against  potential allergies, they often pre-med patients with injectable Benadryl.

I have seen people who get manic on steroids.  (I don't know their mental health status.)  (I saw one very calm nurse walk out of a patient's room dripping wet.  The patient had dumped the ice bucket over the nurse.  The nurse calmly explained, "She's on steroids.")  I've sometimes seen anti-psychotics prescribed (including for persons with no pre-existing mental health issues.)

It sounds like they've even tried dexamethasone FOR bipolar, but I don't know the outcome. (1995 paper). http://www.ncbi.nlm.nih.gov/pubmed/7755142, http://www.ncbi.nlm.nih.gov/pubmed/2071561

There are some case reports of chemo causing mania. http://www.ncbi.nlm.nih.gov/pubmed/17888816, http://www.ncbi.nlm.nih.gov/pubmed/16261598

It sounds like with cis-platinum, lithium levels may need to be measured (if you would be getting both drugs). http://www.ncbi.nlm.nih.gov/pubmed/7511066

If you don't want to have dexamethasone, I'd certainly talk to your onc!  Maybe they can eliminate it from your chemo regimen (if you want to handle the potential energy, nausea/vomiting, allergy issues), or give you a shorter acting agent (such as hydrocortisone sodium succinate.)  Now know I don't have much experience with chemotherapy, knowing only they very frequently include dexamethasone routinely in chemo regimens.  But its certainly worth asking about.

Hello

I just wanted to say re Decadron steroid

This was the med administered

to me while on Taxol

and it affected me

like an elevator

right UP

then crashing down after 3 days

Ill never forget it

an awful medication for me

Each person is different

Sierra :)

take care

yeah I feel real good the day after chemo then for 2-3 days I am suicidal-totally depressed. Its horrible. Then it just ends-the depression just lifts.

Can't remember the steroid I took during chemo, but the frenzy of 2 days followed by the WORST crash, and it was cumulative - the last infusion was much, much, much worse than the first.

Don't know the purpose of the steroids, but I'd make sure to talk to a GOOD psychopharmacologist if I was bi-polar before taking them.  Does everyone on your oncology team know you are bi-polar?

I talked to my doc, and he gave me a lower dose - 4 mg a day for 4 days.  I did okay this time around, and am hoping that continues.  I still haven't told EVERYONE that I'm bipolar, since I'm not taking meds for that right now, but I probably should.  I just hate how even doctors react when I tell them, i can almost SEE the change once they know.  They just approach you in a different way, and I don't like that.