Header Ads

Could Trump's dexamethasone treatment for covid give him 'roid rage?' Powerful steroid is linked to aggression, mood swings and confusion

 President Donald Trump is being treated for COVID-19 with a steroid that is recommended for severe cases of the illness and that comes with risks of serious side effects, including mood swings, aggression and confusion.

Trump's medical team on Sunday said the president was started on dexamethasone, a generic steroid long and widely used to reduce inflammation associated with other diseases. The steroid was begun after Trump experienced low oxygen levels. 

'The president is going to get a short course so I’m not worried about long-term effects of dexamethasone,' Dean of Brown University's School of Public Health, Dr Ashish Jha told Fox News

'But we definitely see in 30-40 percent of people pretty substantial effects...[of] the anxiety, the agitation.' 

Research has shown that just a few days on dexamethasone can leave patients with memory and cognitive deficits. Corticosteroids - the class of drugs dexamethasone belongs to - may cause psychiatric side effects in anywhere from 1.8 to 57 percent of patients taking them.  

Experts' first worry was that the use of dexamethasone to treat Trump suggested he was very sick, since the $6 steroid may be dangerous to people with mild COVID-19. 

But because it's been linked to everything from mania to memory problems, and aggression to psychosis, some are also concerned that the president's judgement could be impaired as he reportedly continues to work through his illness. 

Experts are concerned that Trump could develop 'roid rage' due to his treatment for COVID-19 with the steroid dexamethasone. Agitation, mood swings and even confusion are relatively common side effects of the class of corticosteroids to which the drug belongs  

Dr Ashish Jha, former Harvard Global Health Institute Director, said he is 'concerned' about Trump becoming agitated and aggressive as side effects of dexamethasone when asked about 'roid rage' on Fox News

Dr Ashish Jha, former Harvard Global Health Institute Director, said he is 'concerned' about Trump becoming agitated and aggressive as side effects of dexamethasone when asked about 'roid rage' on Fox News 

Trump tweeted Tuesday morning that he is 'FEELING GREAT!' in all caps that might suggest anger, but are rather standard fare for him

Trump tweeted Tuesday morning that he is 'FEELING GREAT!' in all caps that might suggest anger, but are rather standard fare for him 

'Steroids are always very dangerous medications to use,' Dr Edward Jones-Lopez, an infectious disease specialist at the University of Southern California in Los Angeles told Reuters.

'That is why it [dexamethasone] is used in severe to critical patients...There can be neuropsychiatric side effects. These are medications that we use verdy, very carefully.'  

White House officials have painted a rosy picture of Trump's condition, saying he could be discharged from the hospital as soon as Monday. 


But dexamethasone has typically been reserved for more serious cases. 

A study in June that was hailed as a breakthrough showed that use of the steroid reduced death rates by around a third among the most severely ill hospitalized COVID-19 patients.

Dexamethasone is used to treat immune system disorders, inflammatory conditions, breathing issues and other conditions by decreasing the body's natural defensive response, which can overreact causing additional problems.

The Infectious Disease Society of America says dexamethasone is beneficial to people with critical or severe COVID-19 who require extra oxygen. But studies show the drug may be harmful in people with milder COVID-19 because it can suppress their natural immune response.

In addition, side effects can include physical problems such as blurred vision and irregular heartbeat, as well as personality changes and difficulty thinking, according to the International Myeloma Foundation.

Dexamethasone is also a member of a group of long-acting glucocorticoids that comes with a particularly high risk of delirium, confusion or disorientation, as well as depression caused by withdrawal when treatment is over, compared to short-acting steroids.  

The receptors that dexamethasone and other steroids target are not only key to combating dangerous inflammation, but play central roles in our memory cognition and the synaptic activity that keeps our thoughts flowing clearly and quickly. 

White House physician Dr Sean Conley disclosed that Trump had been treated with dexamethasone - but not how much, or how many times he'd been dosed

White House physician Dr Sean Conley disclosed that Trump had been treated with dexamethasone - but not how much, or how many times he'd been dosed 

A 2019 case report on a man who developed psychosis after an injection of dexamethasone to his scrotum, describes steroid-induced psychosis 'a well-documented phenomenon,' although an 'uncommon' one. 

The report, from Baylor University Medical Center, also notes that research on the mental disturbances linked to dexamethasone or other steroids is sparse.  

So there are not exact statistics for how many people treated with the steroid develop mood swings, aggression or any other psychiatric issues. 

But these are considered 'more common' side effects of the drug and at least 79 instances were already recorded in 1985. 

Most of those 79 people somewhat lost touch with reality, about 40 percent became depressive, 28 percent became manic and about 10 percent of people who had the bizarre reaction became delirious. 


For most people, these strange mental disturbances appeared within less than two weeks after they received dexamethasone. They subsided within a few days for some, but lasted weeks for others (the most intense symptoms went away more quickly, while depression and mania lingered a bit longer). 

The main risk factor for psychiatric effects is taking a high dose of steroids. 

According to a Mayo Clinic study on steroids and psychiatric effect, the risk of having delirium, depression or other psychiatric side effects is 'minimal' so long as someone is getting 40mg or less a day. 

White House physician Dr Sean Conley has not disclosed what dose of dexamethasone Trump got or is getting, but it was given to COVID-19 patients at a dose of just 6mg per day, so it's highly unlikely Trump's dose puts him in a high risk category.  

However, dexamethasone is a common steroid used in many patients who have low oxygen as a result of COVID-19 and is typically harmless, said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

No comments