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.

Unlocking the Mystery of Autoimmune Disease

A key feature of the immune system is its ability to discriminate between self and non-self.

When the mechanisms that prevent the immune system from attacking itself break down, it can result in autoimmune disorders such as multiple sclerosis, rheumatoid arthritis, Crohn’s disease and diabetes.

Now researchers at Columbia University Medical Center claim they have not only found out why people with autoimmune diseases attack their own tissues and organs, but also how to correct the problem.

According to a study just published in The Journal of Clinical Investigation scientists have identified a defect in the T cell regulatory pathway which normally controls autoreactive T cells.  The majority of people with Type 1 diabetes who were tested were found to have a defect in CD8+ T cells that impacted their recognition of a common target structure known as HLA-E/Hsp60sp. More importantly, researchers were able to successfully correct the defect in-vitro.

For decades, autoimmune diseases have been treated by reducing overall immune response. That’s been effective in extending life spans, but has been hard on the quality of life for many of those patients,” said lead researcher Hong Jiang, M.D. Ph.D.

Current therapies for treating autoimmune disease include steroids, which systemically suppress the immune system, resulting in multiple side effects, including weight gain and increased susceptibility to infections.  Therapies based on this new research are designed to selectively suppress immune responses to self-antigens without damaging the body’s normal anti-infection and anti-tumor responses.

This research is significant. The Columbia University scientists believe that this greater understanding of the defect could eventually lead to prevention of autoimmune diseases altogether.

SRxA’s Word on Health is keeping everything crossed.