What Causes Hypermanic Episodes And Depression?

Posted on Wed, 15 Oct 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 15 Oct 2014 Answered on

Mon, 3 Nov 2014 Last reviewed on

Question : my husband is on 15mg prednisolone a day. he had a hypermanic episode in April/May this year because of (at the time up to 50mg prednisolone a day) the cortisone. he's now suffering from severe depression and is having ect which doesn't seem to be working. he's had 11 treatments and doesn't seem a lot better. the last one his bp spiked to about 230 and they are now testing him for some sort of I think it was a tumour and something to do with the adrenal glands. I thought the name was something like XXXXXXX - chrome - something? Do you have any ideas what it would be?

the other drugs he's currently on are methotrexate (one dose p/week) because initially the prednisolone was administered for polymyalgia; and daily, quetiapine 50mg; amlodipine 5 mg (because his bp went up since ect); oxazepam 2 - 3 x 7.5mg; duloxetine 60mg.

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
Stroid induced Depression/Mania

Detailed Answer:
Good day,
Noted your concern. It is common for people to develop depression/mania while on high dose steroids. Since he is on steroids for a long time, it is difficult to wean him off quickly. Methotraxate is a steroid sparing drug and slowly we should try to taper steroids. You should meet an endocrinologist to do that.

The disease which you are mentioning is "Haemochromatosis: which is excess iron deposition in various organs. It has nothing to do with adrenal tumour. Are you mentioning about " Pheochromocytoma" ?? This is an adrenal tumour which can cause heart beat to go up and also cause high blood pressure.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (3 hours later)

yes, yes, thank you . that's the name 'pheocromocytoma'. is there any connection with the likelihood of this and high dose steroids?

Answered by Dr. Binu Parameswaran Pillai (19 minutes later)

Brief Answer:
No relation

Detailed Answer:
No, Pheochromocytoma is a tumour in the adrenal which secrete adrenaline and noradrenaline. This has nothing to do with high dose steroids.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar