I just found this little fact out the hardway..............I am about to have knee surgery and my knee doc gave me a cortisone shot in my knee...............about 6 hours later I found myself in a manic state as bad as I have felt..........even taking my usual anti-manic Seroquel on top of my Lamictal had little effect........I was told by my PD to double the dose of Seroquel to stop the mania........three days later still manic. My knee doc knew I am bipolar and he gave me steroids anyway..........I guess a lot still don't know that they must be used with caution with people that have bipolar.

Thanks for the info, CK.

Does this report include topical solutions? Because I have to use a topical steroid for my psoriasis...

Here is a list I found on the internet of drugs that can cause mood symptoms in people with Bipolar Disorder.........................<TABLE width=600 align=center border=0><TBODY><TR><TD>

</TD></TR><TR><TD>Medicines That Can Cause Mood Disorders

The term "mood disorders" refers to a group of illnesses that cause persistent changes in mood and behavior serious enough to impair functioning. Common mood disorders include depression and bipolar disorder (manic-depressive disorder).

Depression is an illness that consists of depressed mood, fatigue, and a loss of interest in activities that usually are pleasurable. Depression can rob a person of the joys of life, disrupt relationships, and interfere with work and daily activities.

Mania may be loosely thought of as the opposite of depression. It is characterized by very happy or irritable moods and increased energy. A related condition called hypomania is a mild form of mania. It is characterized by emotional highs, scattered thoughts, and overactivity in the absence of dangerous, reckless or destructive behavior.

Bipolar disorder is a mental illness that causes people to have episodes of serious mania and depression. The person's moods swing from overly "high" and irritable (mania) to sad and hopeless (depression), with periods of normal mood in between.

Certain drugs prescribed for various medical conditions have been found to cause depression or mania in some people. But not all people who take these drugs will experience mania or depression.

If you do experience these or other disturbing side effects, call your doctor immediately. Do not stop taking the medicine unless directed to do so by your doctor. In all cases, the risk of side effects must be balanced against the risk and discomfort of not treating the disease.

What are some of the more commonly used drugs that can cause mania?
Mania can occur as the result of drug treatment for many medical problems, especially in people already susceptible to mood disorders. The drugs that can cause mania include:

Amphetamines -- Central nervous system stimulants used to treat childhood hyperactivity, obesity, and narcolepsy. Examples include Dexedrine, Ritalin, Adderall and their longer-acting counterparts, Concerta and Metadate.

Anticholinergics -- A group of medicines used to relieve cramps or spasms of the stomach, intestines, and bladder. Examples include Anaspaz, Bentyl, Gastrosed, Levbid and Symax.

Benztropine -- A medicine used to treat Parkinson's disease.

Bupropion -- A medicine used to treat depression.

Corticosteroids -- A group of medicines that decrease inflammation (swelling) and reduce the activity of the immune system. Corticosteroids may be topical (rubbed on the skin), oral (swallowed), or inhaled through the nose or mouth. Topical steroids are used to treat various skin problems such as poison ivy, and include Hydrocortisone, Clobetasol, and Triamcinolone. Oral steroids are used to treat a variety of inflammation-based diseases, including asthma and lupus, as well as to help prevent transplant rejection. Examples include Prednisone and Methylprednisolone. Inhaled steroids are used to reduce inflammation associated with asthma and nasal allergies. Examples include Flonase, Nasocort, Nasonex, Flovent, and Azmacort.

Cyclosporine -- A drug used to suppress the immune system to prevent the rejection of transplanted organs.

Baclofen -- A muscle relaxant and antispastic agent often used to treat multiple sclerosis and spinal cord injuries.

Bromocriptine -- A drug used to treat Parkinson's disease.

Captopril -- A medicine used to treat high blood pressure.

Cimetidine (Tagamet) -- One of the histamine H2-receptor antagonists, a group of medicines used to prevent and treat duodenal ulcers. These medicines also are used to prevent and relieve heartburn, acid indigestion, and sour stomach.

Disulfiram (Antabuse) --A medicine that produces sensitivity to alcohol and results in a highly unpleasant reaction when the person taking it drinks alcohol. It is used to treat alcoholism.

Hydralazine -- A medicine used to treat high blood pressure.

Isoniazid -- A drug used to treat tuberculosis, or TB.

Levodopa (Dopar, Sinemet) -- A medicine used to treat Parkinson's disease.

Levothyroxine (Synthroid) -- A drug commonly prescribed as a thyroid hormone replacement. It is used to treat patients whose thyroid glands are not producing enough hormones on their own.

MAOIs -- A group of medicines used to treat depression. Examples include Nardil and Parnate.

Methylphenidate (Ritalin) --A mild central nervous system stimulant used to treat attention-deficit hyperactivity disorder (ADHD).

Metrizamide (Amipaque) -- A special medical dye used in certain radiology tests. These dyes help doctors visualize blood vessels and organs.

Opioids -- A class of narcotics used to relieve moderate to severe pain. These drugs have a high potential for abuse and addiction. Examples include Codeine, Demerol, Darvocet, Morphine, and Percodan.

Procarbazine -- An anticancer drug commonly used to treat Hodgkin's disease and lymphomas.

Procyclidine -- A medicine used to treat Parkinson's disease and adverse effects of anti-psychotics.

Trihexyphenidyl (Artane) -- A medicine used to treat Parkinson's disease.

Yohimbine -- A drug used to treat male impotence.

What are some of the more commonly used drugs that can cause depression?
The following drugs have been reported to cause depression in some patients. Elderly people are particularly at risk.

Acyclovir (Zovirax) -- An antiviral drug used to treat shingles and herpes.

Alcohol

Anticonvulsants -- A drug used to control epileptic seizures. Examples include Celontin and Zanontin.

Asparaginase (Elspar) -- An anticancer drug.

Baclofen (Lioresal) -- A muscle relaxant and antispastic agent often used to treat multiple sclerosis and spinal cord injuries.

Barbiturates -- A group of central nervous system depressants that slow down brain function. These medicines have been used to treat anxiety and to prevent epileptic seizures. They are commonly abused. Examples are phenobarbitol and secobarbitol.

Benzodiazepines -- A group of central nervous system depressants often used to treat anxiety and insomnia, and relax muscles. Examples include Ativan, Dalmane, Halcion, Klonopin, Librium, Valium, Xanax and Restoril.

Beta-adrenergic blockers -- Also known as beta-blockers, these medicines are used in the treatment of various heart problems, including high blood pressure, chest pain caused by angina, and certain abnormal heart rhythms. They may also be used to treat migraine headaches. Examples include acebutolol, atenolol, propanolol, bisoprolol, metoprolol, nadolol, and timolol.

Bromocriptine (Parlodel) -- A medicine used to treat Parkinson's disease.

Calcium-channel blockers -- A group of medicines that slow the heart rate and relax blood vessels. Calcium channel blockers are used to treat high blood pressure, chest pain, congestive heart failure, and certain abnormal heart rhythms. Examples include verapamil, diltiazem, and nifedipine.

Corticosteroids -- A group of medicines that decrease inflammation (swelling) and reduce the activity of the immune system. Corticosteroids may be topical (rubbed on the skin), oral (swallowed), or inhaled through the nose or mouth. Topical steroids are used to treat various skin disorders, including poison ivy, and include Hydrocortisone, Clobetasol, and Triamcinolone. Oral steroids are used to treat a variety of inflammation-based diseases, including asthma and lupus, as well as to help prevent transplant rejection. Examples include Prednisone and Methylprednisolone. Inhaled steroids are used to reduce inflammation associated with asthma and nasal allergies. Examples include Flonase, Nasocort, Nasonex, Flovent, and Azmacort.

Cycloserine (Seromycin) -- An antibiotic used primarily to treat tuberculosis, or TB.

Dapsone -- An antibacterial/anti-infection medicine used to prevent and treat a type of pneumonia called PCP pneumonia. Dapsone also is used to treat leprosy and a skin problemcalled dermatitis herpetiformis.

Disopyramide (Norpace) -- A drug used to treat abnormal heart rhythms, or arrhythmias.

Disulfiram (Antabuse) --A medicine that produces sensitivity to alcohol and results in a highly unpleasant reaction when the person taking it drinks alcohol. It is used to treat alcoholism.

Estrogens -- A class of female hormones often used in hormone replacement therapy (HRT) to treat menopause symptoms and to prevent or treat osteoporosis. Examples include Premarin and Prempro.

Fluoroquinolone antibiotics --A class of antibiotics used to treat respiratory tract infections, including chronic bronchitis, pneumonia, and bacterial sinusitis. Levaquin is one example of fluoroquinolone antibiotics.

Histamine H2-receptor antagonists -- Medicines used to prevent and treat duodenal ulcers. These medicines also are used to prevent and relieve heartburn, acid indigestion, and sour stomach. Examples include Axid, Mylanta, Pepcid, Tagamet, and Zantac.

HMG-CoA reductase inhibitors (statins) -- A group of medicines used to lower cholesterol, protect against damage from coronary artery disease and prevent heart attacks. Examples include Mevacor, Zocor, Pravachol, Lescol, and Lipitor.

Interferon alfa (Roferon-A) -- A highly purified protein used to treat certain cancers and chronic, active hepatitis B.

Isotretinoin (Accutane) -- A drug used to treat severe acne.

Mefloquine (Lariam) -- A medicine used to prevent or treat malaria.

Methyldopa (Aldomet) -- A drug used to treat high blood pressure.

Metoclopramide (Reglan) --A medicine that increases the contractions of the stomach. It is used to help diagnose certain disorders of the stomach and/or intestines. It also is used to prevent nausea and vomiting that may occur after treatment with anticancer drugs.

Metrizamide (Amipaque) -- A special medical dye used in certain radiology tests. These dyes help doctors visualize blood vessels and organs.

Metronidazole (Flagyl) -- An antibacterial agent used to treat infections.

Narcotics -- A group of drugs used to relieve intense pain and suppress coughs. These drugs have a high potential for abuse and addiction. Examples include Codeine, Demerol, Darvocet, Morphine, and Percodan.

Progestins, implanted (Norplant) -- Medicines used for birth control.

Sulfonamides -- A group of drugs used to prevent and treat infections.

When a medicine produces symptoms of depression, mania, or both, your doctor may recommend discontinuing the drug or reducing the dosage (if possible). If this is not possible, your doctor may treat the manic or depressive symptoms with other drugs.

© Copyright 1995-2005 The Cleveland Clinic Foundation. All rights reserved

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