Steroid Side-Effects & Seven-Fold Suicide Risk

Steroids are used to treat a variety of conditions such as rheumatoid arthritis, systemic lupus erththematosus (lupus), myositis (inflammation of the muscles) and vasculitis (inflammation of the blood vessels).  They work by decreasing inflammation and reducing the activity of the immune system, thereby minimizing  tissue damage and organ failure.  At times they can be life-saving.

However, they are always prescribed with caution due to the long list of well-documented physical side-effects such as:

In addition, steroids are known to cause psychological problems such as sudden mood swings, nervousness, restlessness, and depression.

Now a new study reveals another worrisome side-effect.  According to a group of French researchers, patients prescribed oral steroids are nearly seven times more likely to commit or attempt suicide.

In the largest study of its kind, researchers followed 372,696 adult patients treated with oral steroids between 1980 and 2008 and compared them to patients with similar conditions who were not prescribed steroids.

The results of the study were published last month in the American Journal of Psychiatry. They showed that patients taking oral steroids were seven times more likely to commit or attempt suicide compared with those with the same underlying medical disease not treated with oral steroids.

The steroid treated group was also twice as likely to suffer from depression and more than four times as likely to suffer mania.

The authors of the study concluded primary care physicians should educate patients and monitor oral steroids closely. Lead author Dr Laurence Fardet, a consultant in internal medicine at Saint-Antoine Hospital, Paris, called for caution in prescribing oral steroids: “Where it is essential to prescribe a glucocorticoid, patients and their families should be informed about the possibility of these severe adverse events.”

Have you or your loved ones suffered physical or psychological side-effects from oral steroids? Share your stories with us.

Game Set and Match Sjögrens

Earlier this year, we brought you news of Serena William’s  health scare after she was diagnosed with pulmonary embolism. Serena has since made a successful comeback to pro tennis, winning 18 straight matches between July and September, including titles at Stanford and Toronto, and becoming a finalist in the US Open. However, by some strange, sad twist of fate, her sister, Venus Williams, was forced to withdraw from the same tournament after being diagnosed with Sjögren’s syndrome.

Sjögren’s – a condition in which the body’s immune system attacks its own healthy tissues. It primarily affects glandular tissues – most notably the tear and saliva glands. It can result in dry eyes and a dry mouth. In addition, patients can experience muscle and joint aches and pains, as well as debilitating fatigue.

While a combination of genetic and environmental factors can lead to Sjögren’s, as with many autoimmune diseases, the onset of the condition is often preceded by an infection. It’s understandable how these symptoms might make it difficult, if not impossible, to play tennis at a high level.

I think I’ve had issues with Sjögren’s for a while. It just wasn’t diagnosed,” Williams told ABC News. “The good news for me is now I know what’s happening.”

While Sjogren’s has no cure, there are treatments that make symptoms more manageable. In addition to over the counter (OTC) eye drops and mouth preparations, prescription products are available. They include Evoxac® (cevimeline), Salagen® (pilocarpine hydrochloride) and Numoisyn™ for dry mouth and Restasis® (cyclosporine ophthalmic emulsion) and Lacrisert® (hydroxypropyl cellulose ophthalmic insert) for dry eye. Additionally, anti-inflammatory drugs can reduce joint and muscle inflammation; and certain drugs can help to either suppress or modulate the overactive immune response.

Let’s hope Venus can recover as fast as her sister and that we can look forward to a 9th grand slam finals between the pair.