Steroid Medicines and Behavior

What are steroid medicines?

Steroids are medicines used to help treat many illnesses and health conditions. Examples include dexamethasone, prednisone (prednisolone), and methylprednisolone. Your health care provider may prescribe steroids to:

• Relieve inflammation and reduce symptoms such as swelling, pain, and redness
• Help manage symptoms such as nausea, vomiting, and headaches
• Treat severe allergies or asthma
• Treat certain cancers
• Prevent or treat certain side effects of treatments

Steroid medicines can be very important for treatment, but they can have side effects and cause changes in moods and behavior.

How steroids might affect your child

Steroids may change how your child acts, thinks, and feels. Side effects may include changes in: 

• Behavior: Your child may have angry outbursts, be restless, cry more than normal, or seem very energetic (hyperactive).
• Mood and emotions: Your child might seem angry, irritable, depressed, or anxious. They may have rapid mood swings, during which their emotions change quickly and often.
• Thinking: Your child may get confused easily, forget things, be easily distracted, or have trouble paying attention.
• Sleep: Your child might find it hard to go to sleep or stay asleep. 
• Senses: Rarely, your child might see or hear things that are not really there (have hallucinations).

Side effects of steroids can be seen in children of any age. Infants and toddlers may show these symptoms too, including sleep problems, irritability, and crying uncontrollably.

These symptoms will usually go away after your child stops taking steroids, but it may take several weeks for them to go away. 

How to manage steroid side effects in your child

First, stay calm. The changes are usually temporary and are a side effect of your child’s medicine. 
 
To help your child cope, you can:

• Try to ignore minor problems if they are not harmful.
• Give your child time to calm down. Provide a quiet place if needed.
• Encourage your child to do deep breathing and other relaxating activities.
• Comfort and support your child. Help them talk about what they are feeling.
• Avoid big changes in routines. Keep your child’s surroundings and schedule as normal as possible. 
• Encourage your child to go outside and play or do physical activities to release extra energy. 
• Keep a regular sleep routine. If your child has sleep problems, ask your care team if your child should take steroids early in the day to prevent sleep problems at night.
• Keep a journal to track your child’s mood and behavior. This can help you notice patterns of behavior and share information with your care team.

If your child or siblings notice the changes, explain side effects using words they can understand. Tell them that some medicines can change the way people think, act, and behave. Let your child help you plan ways they can cope. 

When to get help for mood and behavior changes

Let your care team know about any changes in your child’s behavior, emotions, or thoughts. The care team may refer you to psychology and mental health services at your treatment center. Services such as psychology, psychiatry, child life, social work, spiritual care, and music therapy can help your child learn coping skills and find ways to better express their thoughts and feelings.

Your care team can help you: 

• Know how your child’s medicines might affect behavior, emotions, and thinking
• Learn strategies to calm or comfort your child
• Make a medication plan to address certain side effects

Talk to your care team about any symptoms or side effects. Always read medication labels and follow dosing instructions carefully. 

Do not start or stop any medicine without talking to your care team. 

Questions to ask your care team

• How will steroids affect my child’s mood and behavior?
• How long do these changes usually last?
• What other symptoms or side effects should I watch for?
• How can I help my child cope with mood changes?
• Are there ways to help manage side effects of steroids?
• What support is available for my child and other family members?
• When should we contact the care team?