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Solu-Medrol and Anxiety

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Updated May 22, 2007

Solu-Medrol is a corticosteroid which is given intravenously in high doses (500 to 1000 mg/day for three to seven days) to shorten the duration of a multiple sclerosis (MS) relapse by reducing inflammation and restoring the blood-brain barrier.

Solu-Medrol is notorious for bringing on feelings of anxiety. In my experience, these feelings can range from a mild nervous state to downright paranoia. During and immediately after one of my Solu-Medrol series, I had episodes of terror at night, when I would lie in bed convinced that I would fall down the stairs (down the hall on the other side of a closed door) if I got up to go to the bathroom. During the day, people I saw walking along the street were potential terrorists.

Corticosteroids, MS and Anxiety

Solu-Medrol is the liquid form of methylprednisone, a powerful corticosteroid. Corticosteroids cause anxiety and fear by inducing certain chemical changes in specific neurons, thereby temporarily strengthening or weakening neural pathways which regulate these feelings. When we are then exposed to situations that are stressful, our responses are much stronger than usual.

MS relapses come with their own set of worries and uncertainties, as we never know how bad things will get – and how bad they will stay after the relapse is over. Add to this the stress of missing work, frequent clinic visits and physical discomfort and limitations caused by the relapse. Needless to say, this is not the time to surf the Internet looking for the worst accounts of MS that you can find and speculating about your prognosis.

Tips for Managing Solu-Medrol Anxiety

  • Avoid Stressful Situations: This is best for everyone. Against my advice, a friend of mine took his four-year-old son to a Chuck E. Cheese’s restaurant after a Solu-Medrol infusion, where the flashing lights, whining children and sheer volume of the place induced an episode of what he called “‘roid rage,” where he almost dismantled a video game that he claims “cheated.” Remember, if a situation “plucks at your nerves” during the best of times, it may send you over the deep end during your Solu-Medrol treatments. This goes for people, too. Tell the in-laws to visit in a week or so.
  • Don’t Go To Work: It is best if you rest during the days that you are getting your infusions and for a day or two afterwards. In addition to protecting your physical energy level, staying home from work will protect you from saying things or making decisions that are influenced by Solu-Medrol and the accompanying anxiety. Against my better judgment, I once participated in an important conference call from my hospital bed during in-patient Solu-Medrol treatment. I could not remember what had been said or follow the conversation at all, and apparently gave way more advice than I was asked for, although I don’t remember a word of the call.
  • Keep Calm: Try to stay home, stay calm and be quiet during this time. Read a light novel (something from the Shopaholic series is probably a better choice than something by Patricia Cornwall or Steven King), rather than watching action-packed television shows. Light a candle. Practice deep breathing exercises.
  • Extra Love: Have a loved one gently remind you that what you are feeling is a side effect of the steroids. Warn them ahead of time that you may experience anxiety and mood swings (you also can apologize to them in advance for anything hurtful that you may say). Ask that they give you a little extra understanding and patience during this time.
  • Other Reminders: No kidding, write notes to yourself on Post-Its that you place on your mirror and the refrigerator that say something to the effect of: “Everything is okay.” or “I am nervous because of the Solu-Medrol. It will be all right.” It may sound silly, but it might help.
  • Ask For Help: Ask your doctor for a prescription of an anti-anxiety medication before you start your Solu-Medrol treatment, so that you have it on hand. Do not wait until it is 4:00 am and you are convinced that you are having a psychotic break to try and obtain it. It does not mean you are weak if you need it. You may not need it. If you do need it, you will be really happy that you have it.

Learn Some Tips for Managing Solu-Medrol Side Effects

Source:

Korte SM. Corticosteroids in relation to fear, anxiety and psychopathology. Neurosci Biobehav Rev. 2001 Mar;25(2):117-42.

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