I have had 3 Fec and had my first of 3 Docetaxyl last week and have really suffered with the effects of steroids (as well as all of the other side effects!). My steroid dosage for the last chemo was 16mg for 3 days, starting the day before chemo, followed by 6mg day 4, 4mg day 5 and 2mg day 6. I was ok for the first 2 days after chemo but as soon as the dosage dropped, I felt hugely emotional and desperate. Angry, crying, completely inconsolable and irrational at times. As well as not sleeping and severe constipation. My chemo nurse has suggested that I am suffering from ‘steroid psychosis’. I am due to have my next dose in 2 weeks and will see my oncologist before then, but wondered whether anyone has experienced this? I am told that there may be an option to reduce the dosage after the first day - has anyone done this and what was the impact? Any thoughts gratefully received.
I was at the clinic and another patient was describing similar symptoms to yourself and it was also called “steroid psychosis” there.
For my first FEC infusion I was prescribed Dexamethosone which is a steroid I had a previous bad reaction to. The consultant insisted that I took this and said it was for “sickness and vomtiting”. Instead of psychosis I had a bad reaction of being weak and breathless and dizzy. This was in addition to a bad reaction I had to the antisickness drug “Metoclopramide”.
My suspicion is that a steroid is being presribed with FEC-T to try and dampen down inflammatory reactions to the chemo drug.
To add insult to injury I also had uncontrollable sickness and nausea, even with the Dex.
What I did for subsequnt cycles was to change to another steriod called Prednisolone wnich I had used previously and reacted well to. I also added Benadryl and Claritine.
It’s quite possible that you could have the same reaction to another steroid as well of course. Might be worse discussing with your consultant. Pred also has emotional side effects listed. If you can’t use any steroid maybe consider Benadryl. I’m under the care of an Immunologist (for a pre-existing disease) and he suggested this to me.
If you do change steroid or decide not to take the steroid please make sure that the nurse doing the infusion knows this. Some put extra drugs into the infusions without telling us (like Dex) and some give us extra drugs to take by mouth without telling us what they are. They kept giving me Dexamethosone to take even through they knew I had changed to Pred. The nusre would hand me the drugs in a paper cup and I had to keep asking them exactly what they were (and it was like trying to get blood from a stone sometimes) as they were so busy and on automatic pilot.
It was a real palaver for me to get Prednisolone. They didn’t have any in the clinic and the hospital pharamacy was a long walk away and a long wait. In the end I asked my GP for a prescription. I ended up taking Pred all through my last FEC-T and then tapering off as I was so sick and weak from the chemo drugs.
Really sorry to hear this happened to you. Hope they can sort it out.
p.s. I just found this poster which discusses some side effects of Dex and a change to the regime and dosing (they now use 1 dose of Dex instead of days)
poster-submission.com/cdrom/download_poster/37/27388/1542P
Hi,
I have read a lot about Dex and as a health care professional myself, do not take any drugs if it is for “routine only” as is Dex. I read loads and made an informed decision to decline any offers. When I went for my first chemo, I told them I am not having the Dex, but I was then coerced by 2 nurses to have it - I backed down and “let them” put it in my drip - I was too nervous to stand up for myself and refuse it.
Not this time. I have given them back the bottle of tablets and seen my main nurse leader, and told her if I am put in that position again I will walk out!! She has now marked it in my notes not to offer it to me.
It takes 36-54hours for Dex to get out of your system, so if you are taking as prescribed, can take weeks to get out of your system. There are some significant side effects.
I have looked into this and with the anti sickness i am taking, it is of no benefit to me personally.
Emend - has an influence but not stated what sort of influence.
Ondasatron - enhances, but for me when I took this, and spiked a temp and ended up in A&E
Donperidone - no influence.
My sickness was controlled so didnt need “extra enhancement”
I took over the counter anti histamines, so dont need it as an anti histamin. (Loratindine helps with Gcsf)
I had no problems with mood, sleep or food cravings or the munchies.
But, and this is the big but, I did all this research for my own personal risk/benefits and it has worked for me.
Kindest
Amanda
xx