If you suddenly feel depressed or tired, it could be due to steroid anti-inflammatory medications prescribed by your doctor. These medications, commonly prescribed for arthritis, eczema or asthma, can alter brain chemistry and increase the risk of developing mental health problems.

Glucocorticoids, a family of steroids that includes cortisone and prednisone, have the highest risk of triggering mental problems, say researchers at Leiden University in the Netherlands, who analyzed the medical histories of more than 700 patients in their 60s.

CORTICOSTEROID MEDICATIONS CAN ALTER THE WHITE AND GRAY MATTER OF THE BRAIN

According to doctoral researcher Merel van der Meulen, from the Department of Medicine in the Division of Endocrinology at Leiden University Medical Center and lead author of this study, previous research conducted with people with Cushing’s disease, who have very high levels of the body’s own glucocorticoid, cortisol, shows that long-term exposure to glucocorticoids can affect both brain function and structure.

“We wondered whether these effects of glucocorticoids on brain structure could also be observed in the large population cohort of the UK Biobank, including users of inhaled glucocorticoids,” he added.

MAY CAUSE DEPRESSION AND MEMORY AND COGNITIVE PROBLEMS

The researchers used magnetic resonance imaging to compare the brains of patients taking inhaled steroids, orally or by injection, with those of 24,000 people of a similar age who were not taking the drugs. None of the participants had a history of neurological, psychiatric or hormonal problems.

Analyzing the images, they found that the white and gray matter in the brains of those taking steroids was physically different from that of those not using steroids. When white matter is lost, the person feels slower in their responses and may have memory and cognitive problems.

In addition, the scientists found that participants taking systemic steroids had a larger caudate nucleus (this area is related to brain activities such as planning movement execution, learning and memory) and a smaller amygdala (the amygdala is part of the brain’s gray matter and is related to the processing and regulation of emotions).

Among steroid users, depression, feelings of lethargy, and tiredness are common, which could be related to the ability of steroid drugs to modify brain structures. The researchers noted that the effects were less pronounced in patients taking the steroids by inhalation than in those who ingested pills that acted on the entire body. They also felt less of a sense of fatigue.

The dose and duration of steroid drug treatments also played a role. The greatest side effects on the brain were seen in people who took systemic pill medications for a long time.

WHAT ARE STEROID MEDICATIONS USED FOR?

Steroid drugs suppress the immune system’s response and are regularly prescribed for inflammatory conditions, such as:

• Asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Inflammatory bowel disease
• Lupus
• Rheumatoid arthritis
• Multiple sclerosis (MS)

Previous studies found that people who take the drugs for a long time are nearly seven times more likely to attempt suicide and are much more likely to suffer from depression, mania and delirium.

On the other hand, using glucocorticoids for a long time increases a person’s risk of developing certain side effects, such as:

• Increased appetite/weight gain
• High blood pressure
• Osteoporosis
• Diabetes
• Mood swings
• Increased risk of cardiovascular and musculoskeletal diseases.

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