The onset of a reactive depression in patients affected by PMR implies the use of antidepressants ?
If the clinical manifestations of PMR quickly resolve with steroid therapy, what relationship can there be between the PMR and depression?
Probably, patients with PMR become depressed if the diagnosis is not correct and the clinical manifestations (sudden disabling) are not resolved
Dear Jordi,
thank you !
The prolonged use of steroids may influence mood (for usually in a positive way, at least in the early periods.....) .
In a short communication we presented in 2007 during the annual congress of the Italian Society of Geriatrics and Gerontology , we documented that low doses of steroids ameliorated the cognitive performance (evaluated by Mini Mental State Examination) of patients with PMR and modest comorbidities.
In the attached file, you can read it (the text is in Italian, sorry......).
Kind regards.
I'd also add that the temporal course may be quite helpful; if mood symptoms started when steroids either were started or when steroids were tapered, this might well suggest that the mood disturbance is steroid induced. Steroid induced mood disturbances are inherently unstable(as we know that these meds can also cause mania), and standard antidepressants can sometimes precipitate a manic episode(even in patients without a bipolar history). Thus when standard antidepressants are used, caution is advised and lower doses probably make sense. Some might treat with a mood stabilizing drug instead(when it is clear that we are dealing with a steroid induced depression). Hope this helps.
Thank you for your suggestions. They are very useful in the clinical practice.
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