Prednisone is a widely prescribed medication used to manage various health conditions, ranging from inflammatory diseases to autoimmune disorders and certain cancers. Many individuals taking this medication report experiencing feelings of “jitteriness,” which can manifest as anxiety, restlessness, or nervousness. This article clarifies why prednisone can cause these feelings and offers strategies for managing them.
Understanding Prednisone’s Action
Prednisone is a synthetic corticosteroid, a class of steroid hormones designed to mimic the effects of cortisol, a hormone naturally produced by the adrenal glands. Cortisol plays a broad role in the body, influencing stress response, metabolism, and immune system regulation. When administered, prednisone is converted in the liver to its active form, prednisolone.
Prednisolone works by binding to glucocorticoid receptors found in nearly all tissues throughout the body. This binding leads to changes in gene expression, which then broadly affects the body’s systems. Its primary therapeutic actions involve broad anti-inflammatory and immunosuppressive effects. It reduces inflammation by inhibiting pro-inflammatory signals and promoting anti-inflammatory ones.
Why Prednisone Causes Jitteriness
The jittery sensation, encompassing anxiety, restlessness, nervousness, and even insomnia, stems from prednisone’s systemic impact, particularly on the central nervous system. Prednisone mimics cortisol, a hormone involved in the body’s stress response, which can lead to increased energy levels and alertness. This can be perceived as an “amped-up” feeling, even though prednisone is not medically classified as a stimulant.
The medication can influence neurotransmitter levels in the brain, such as dopamine and serotonin, which regulate mood and sleep-wake cycles. By altering gene transcription in the central nervous system, prednisone can disrupt the natural diurnal rhythm of cortisol, typically highest in the morning and lowest at night, leading to sleep disturbances. Over 60% of individuals taking prednisone have reported insomnia, suggesting a significant impact on sleep quality and duration.
Coping with Jitteriness
Managing jitteriness and associated symptoms while on prednisone involves several practical strategies:
- Take prednisone in the morning, often with breakfast, to align its stimulating effects with your natural wake cycle. This can help reduce restlessness by bedtime.
- Maintain a consistent sleep schedule and practice good sleep hygiene, including creating a comfortable sleep environment and avoiding electronics before bed.
- Avoid stimulants like caffeine and nicotine, as these can worsen feelings of restlessness and nervousness.
- Engage in light physical activity, if medically appropriate, to help improve mood and burn off stress.
- Practice relaxation techniques such as deep breathing or meditation to help alleviate anxiety.
When to Contact Your Doctor
Contact your healthcare provider if jitteriness or associated symptoms become severe, debilitating, or worsen significantly. This includes if these feelings interfere with daily life, such as causing extreme changes in mood, confusion, or hallucinations. Other concerning symptoms that warrant immediate medical attention include difficulty thinking, or feeling, seeing, or hearing things that do not exist.
Never adjust your prednisone dosage or stop taking the medication without first consulting your doctor. Abruptly discontinuing prednisone can lead to serious side effects, as your body may not produce enough natural steroids to function correctly. Your doctor can help determine if a dosage adjustment or other intervention is necessary to manage side effects safely.