All blog posts from Dr. Allott are provided for educational and informational purposes only. As Dr. Allott is also a licensed medical practitioner, we must make it clear that nothing on the blog is intended to constitute medical advice, consultation, recommendation, diagnosis, or treatment. If you are concerned about your health, please seek appropriate care in your area.

Suicidal Behaviors Linked to Steroid Treatments

/

The research study that I am highlighting this month is especially for mental health professionals who follow my newsletters.  It may explain in part why your patients may do very well and then suddenly they are more depressed or suicidal.  The summary, which follows, discusses how glucocorticoid (steroid) therapy can increase depression and suicidal ideation in your clients.

Most commonly, I have seen Prednisone prescribed for bronchitis or asthma.  Sometimes steroids are also used for acute flare-ups of autoimmune diseases such as MS.  Although the research did not specifically look at local injections of steroids for joint pain, I have seen a few patients in my office struggling with depression and the deepening of the depression within the three-month window of steroid injection(s) for knee pain.

Let me state again: I am not against the use of medications.  I simply want people to know that they may experience depression or suicidal behaviors as a side effect of this medication.  If they wait it out, those side effects will go away.

In a United Kingdom study over a period of 18 years, researchers assessed 372,000 adult patients who received prescriptions for oral glucocorticoid compared with those patients who did not receive such prescriptions.  This is the largest study to date examining the effects of glucocorticoid treatment on adverse neuropsychiatric outcomes.

Simply put: Glucocorticoids increase the risk of suicidal behavior and neuropsychiatric disorders.

Authors Fardet, Petersen, and Nazareth reported “finding a high incidence of neuropsychiatric adverse events in the first 3 months of treatment with glucocorticoids.  Over all, the incidence was 15.7 per 100 person-years at risk.  For patients on their first course of glucocorticoids, it was 22.2 per 100 person-years at risk.  Older men were at higher risk of delirium, confusion, disorientation, and mania, while younger patients were at higher risk of suicide or suicide attempt.  Patients with previous histories of neuropsychiatric disorders and those treated with higher dosages of glucocorticoids were at greater risk for neuropsychiatric outcomes.”

These research findings should give us all pause.  Physicians must exercise caution in administering these drugs.  All of us have monitoring responsibilities.  Information and education for patients and their families are very important in order to eliminate, as much as is possible, adverse reactions and misinterpretations of side effects.

Friends Don't Let Friends Drink Diet Sodas

/

Yes, my title is a take off on an old driving while under the influence of alcohol campaign.  Nonetheless, it just may be an appropriate warning for friends of diet soda drinkers.

Medical researchers in three studies, referenced below, are raising some interesting as well as disturbing findings regarding popular diet sodas.  Findings that struck me as significant include the following:

Drinking at least one diet soda daily increases your risks

  • of obesity by 36%;

  • of cardiovascular events by 61%;

  • of type 2 diabetes by 67%.

Drinking two diet sodas a day increases the likelihood of reduced kidney functions.

Diet soda studies to date have been based on “observational data and have not focused on establishing causality”.  But that doesn’t mean we should dismiss their findings.  Matter of fact, I believe these three articles are calling loudly: “Pay attention!”

Tips for Easing Off the Diet Soda Habit:

  • If you do drink diet sodas, first take note of why.  Many people do it for the caffeine, “the mouth entertainment”, to break the boredom in meetings, to have something to do with their hands.

  • Try taking 2 weeks off.  You may need to replace it with sparking water or green tea. Then, notice how you feel.  Ask yourself questions such as Did the headaches go away?  Is there less muscle skeletal pain?  Have food cravings lessened?

Like breaking all habits, your commitment is key.  Reread those bold facts above and remind yourself that your decision is one based on your vision of a happily healthy you.  Good luck!