Could Prednisone Cause Mood Swings?

If You Experience Mood Changes While Taking Prednisone, You're Not Imagining It

Doctor and patient
If you experience mood swings, your doctors can help you work through it, or stop your medication if needed.. Image © Caiaimage / Rafal Rodzoch / Getty Images

Prednisone is an anti-inflammatory drug that is used to treat a variety of conditions. Prednisone is a type of steroid, known as a corticosteroid. This medication is associated with a variety of side effects, and some of them can be distressing.

One potential side effect is mood changes, such as feeling euphoric, anxious, angry, or depressed. Before starting a steroid drug, patients should tell their physician if they have been diagnosed with any psychiatric disease or are taking any psychiatric medication.

Patients that have a history of depression, psychosis, or another major psychiatric disorder may need follow-up with a psychiatrist when taking prednisone.  

What Is Prednisone?

Prednisone is a corticosteroid drug that is both inexpensive and effective, which translates to it being prescribed frequently. One study in 2001 showed that an estimated 10 million prescriptions are written every year. Some of the conditions that prednisone is used to treat include inflammatory bowel disease (IBD), some autoimmune diseases, asthma, and other allergic disorders. When prednisone was first used 50 years ago it was a revelation: many of these conditions had no effective treatments, and this corticosteroid drug was a boon for patients.

However, in recent years safer, disease-specific treatments have become available and prednisone is starting to take a back seat. In the treatment of IBD, for example, much work is being done to avoid using steroids in patients, and to achieve remission (lack of symptoms and inflammation) using other drugs.

The main reasons for this are the increased risk of infection and the potential for side effects while taking prednisone.

For short courses of prednisone at high doses, changes in appetite, euphoria, jitteriness, anger and sadness are common. These side effects reverse when the prednisone is stopped.

Patients taking prednisone for longer periods may experience insomnia, moon face, hair growth, weight gain, and mood swings. In some cases, these effects reduce when the prednisone is tapered down or discontinued. There are other side effects that are long-term, including glaucoma, cataracts, and bone loss. All of this feeds into the current thinking of getting patients off prednisone as soon as possible or avoiding the drug altogether.

Prednisone and Mood Swings

One of the troubling aspects of prednisone therapy is the potential for mood changes. Patients describe feeling euphoria, anxiety, anger and sadness, sometimes in quick succession, with little provocation or even none at all. If a patient hasn't been adequately prepared for this potential side effect, it can come as a shock.

Prednisone affecting mood is not a rare side effect: it does appear to be fairly common. There is also an association with not just the troubling, but usually short-lived, mood swings, but also with more serious problems such as psychotic disorders, delusions, and dementia.

If you are experiencing severe problems, contact your physician right away, because a change in treatment might be necessary. In some cases, prednisone can be stopped, but in others, it needs to be tapered down slowly, depending on the length of time its being used, the dosage, and the individual patient circumstances. For that reason, it's important to seek help to manage the side effects while the taper is happening.

Can Mood Swings Be Avoided?

The best way to prevent the side effects of prednisone is, of course, to not use the drug. If there are other treatments available, they may be worth considering in the effort to avoid potential side effects. With IBD, for example, there are topical formulations of steroids available that may have fewer potential side effects, and there are other medications that are not steroid-related at all. However, there are cases where prednisone therapy might be the best course for the treatment of a condition, and in that situation, preparing for side effects is the best option.

What to Do About Mood Swings

Not everybody has mood changes while taking prednisone, and most of the time the effects are considered "mild" (though it might not feel that way to you at the time). Knowing that mood swings are a possibility is the first step in coping with them. The second step is to actually be aware of the mood swings when they happen: feeling extreme anger or sadness when it's clear that there's no real reason for it.

Here are some other tips for coping with emotional changes during prednisone therapy:

  1. Talk to your doctor about the potential for mood swings, and find out what you should do if you find your behavior changes to be extreme or to be getting in the way of your daily activities (work, school, and social events).
  2. Tell your family members and friends that the drug you're currently taking can cause mood swings. It may sound like you're asking for permission for unusual behavior, but assure them that this is a very real side effect.
  3. Prepare for changes in your mood before they actually happen. Putting some stress relief tools (meditation, mindfulness, calming rituals) into place before experiencing any mood changes may help.
  4. Take stock of your emotions on a regular basis. Is what you're feeling outsized compared to what's actually happening? Check in with a trusted friend or loved one about how you're feeling.

The Bottom Line

Prednisone is associated with certain side effects, but it is prescribed for a very good reason: it is often effective. The decision to use prednisone to treat any condition is a personal one between patient and physician. When managed properly, using corticosteroids can work well to treat many conditions, but patients and physicians need to work together to cope with the side effects.


Brown ES, Chandler PA. "Mood and Cognitive Changes During Systemic Corticosteroid Therapy." Primary Care Companion to The Journal of Clinical Psychiatry. 2001;3:17-21. 

Kenna HA, Poon AW, de los Angeles CP, Koran LM. "Psychiatric complications of treatment with corticosteroids: review with case report." Psychiatry Clin Neurosci. 2011 Oct;65:549-60.

Mrakotsky CM, Silverman LB, Dahlberg SE, et al. "Neurobehavioral side effects of corticosteroids during active treatment for acute lymphoblastic leukemia in children are age-dependent: report from Dana-Farber Cancer Institute ALL Consortium Protocol 00-01." Pediatr Blood Cancer. 2011 Sep;57:492-498.

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