Prednisolone and mental health

Hi all. I have been diagnosed with proctitis, which they believe is due to ulcerative colitis. I have been prescribed prednisolone retention enemas (I was originally prescribed colifoam but for some reason local pharmacies found it impossible to source). I am quite daunted about UC and am sick of symptoms affecting my day to day life, so was quite keen to start treatment.
However upon reading the leaflet I am less keen... The common side effects are pretty scary especially as I have a history of severe depression. I am very worried about taking this now! I will speak to my doctor in the morning of course, but just wanted to know how others have found this medication?

Thankyou!

everyone is different on side effect with prednisone. Some have slight depression, others a lot of energy. but it's a very effective medication on short term periods, so it could worth a try.

I haven't done the enemas, but I've done steroid suppositories, and those gave me far fewer side effects than oral prednisone has. I'm not sure how the enemas compare to the suppositories, but if they're similar then I think you'll be fine. The suppositories gave me a bit of interrupted sleep and increased appetite, but that's been it. Meanwhile, oral pred makes me HUNGRY and sometimes very angry or moody, and it's given me a lot of acne too. Comparatively speaking, the suppositories were quite mild compared to the oral steroid. And, I did not have to taper off of the suppositories the way that I have to do with the oral prednisone. So I would imagine that if the enemas aren't doing good things for you, you might be able to just stop taking them (please confirm that with your doctor or pharmacist to be absolutely sure). If it were me, I'd give it a try at least. Good luck!

Hi Vickingsnail,
do not worry. the amount of pred that will go in your body will be very low. It is very unlikely that you will get important side effects with enemas. This is the best route of administration to start treating your condition. Wishing you well.

I agree with the others, pred enemas are very unlikely to affect your mental health. I've used them for proctitis with no problems. Now my proctitis issues are not too bad I use Salofalk (mesalazine) suppositories three times a week and I've only had a minute amount of bleeding once in the past six months. Salofalk is the mildest drug of the lot - maybe worth asking your GI whether it might be appropriate for you to use at some point?

Thanks everyone. I've spoken to my doctor who was quite reassuring so we'll see how it goes. Gotta get this under control somehow!
I've tried the salofalk suppositories with no improvement, though hopefully if this helps get things under control I can move down to them?

It could be a possibility to try salofalk (5-ASA) as maintenance therapy after a remission with cortisone I believe even it was a failure at inducing remission.

Keep in mind that Salofalk suppositories contain 1gram of medication and that Pentasa (same medication as Salofalk) ENEMAS contain 4 grams of medication. Pentasa have enemas choice of 2 grams and 4 grams. That could be an option too for you to consider after remission with cortisone. You can check if the product is available with your pharmacist.

We always want to find the mildest treatment possible for sure. IBD and treatment is always about trials. Predictions are hard to make and each patient disease can behave and react differently. let us know how it goes

Vikingsnail said:

I've tried the salofalk suppositories with no improvement, though hopefully if this helps get things under control I can move down to them?

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That's how it's worked out for me. The Asacol tablets are keeping me in remission from the Crohns at the moment and the Salofalk suppositories are stopping the rectal bleeding. There have been times when Salofalk suppositories have not worked and I've had to use pred and other steroids to get everything under control.


Incidentally, at the beginning of my illness I used Pentasa suppositories and they did very little good, and often came out whole or in large pieces when I used the toilet, I just wasn't absorbing them. Then I was given Salofalk (because the pharmacy was out of Pentasa) and it worked for me. Even though it's the same active ingredient, it's in a different carrier (quite greasy) and that seemed to work for my body whereas Pentasa didn't.