My Experience With Nasacort's Rare Side Effect: Suicidal Ideation

As should be evident from the title/summary, this post comes with a major content warning for discussion of suicidal ideation. The shortest version is: I decided to try Nasacort for my seasonal allergies. Just three days later, I was planning suicide. Fortunately, my thoughts were disrupted long enough for me to realize there was something wrong, stop using it, and fully recover. I am sharing this so that if it’s found by others experiencing the same very rare side effect, they’ll know it’s not just them. In my case, I felt completely better within a single day of stopping use.

The events I’m writing about happened at the beginning of June 2018. I haven’t shared this story widely because I don’t want to worry people, although I did mention it on Twitter in 2019. This was a freak incident and does not reflect my overall mental health. But every spring when I resume medicating my allergies, I think of this incident.

I’ve had bad seasonal allergies my whole life. I come from, live in, and love the mid-Atlantic region but I spend a good part of the year congested. In August 2017, I moved back to Pennsylvania. The next spring, my old allergies hit me full in the face. Because the most effective treatment I’ve found, sudafed, requires visiting the pharmacy counter and presenting ID, I was looking at alternatives and decided to try Nasacort.

To the best of my knowledge, most people who use Nasacort do just fine with it. They get real relief and, at most, minor side effects. That’s certainly the case for the friend who told me how helpful she found it. I also now know some people report severe increases to anxiety.

I’ll note that at the time I was taking Viibryd (generic: vilazodone) for anxiety at 40mg/day. What I experienced may have been a medication interaction, which could explain why it’s such a rare occurance.

The Incident

It’s been nearly 7 years, so I’m going to recall the dates the best I can. It was the very beginning of June 2018. My husband was in California for about a week and a half for work. I had just gotten back from a work trip, which is where I’d had a discussion about allergy medication that made me want to try Nasacort. I believe I picked it up with Saturday’s weekly shopping, which would have been on June 2.

I’d had a hard year and was a bit tired, but I was looking forward to my husband’s summer break. I had quilting projects underway. My anxiety was medicated and I was on a pretty even keel. I had interesting projects at work and was about to undertake a project that really excited me, the creation of a Blacklight catalog for our library.

When I remember the incident now, I recall that Monday night after work. I was walking to our local post office (mail was not delivered to the house we rented). During the last three days, I had fallen into felt a deep, hopeless despair. I was planning on ending my life before my husband returned from California. I had only been suicidal at one other point in my life, in my late teens, shortly after my mother was diagnosed as terminally ill. This was as close or closer than I had ever come to it. I planned it the way I had planned to pick up the mail that day. I only had a couple logistical issues to work through.

What happened next was one of those little everyday miracles. A dear friend had sent me the National Audobon Society Field Guide to North American Mushrooms. It was such a small thing and it also completely interrupted the thought patterns. I remembered our recent trip to Harper’s Ferry,¹ where we’d talked about how wonderful mushrooms were and celebrated how they were erupting around us after a storm.

I thought: “I am not actually unhappy right now. I have been looking forward to this summer. I am loved by my friends. I don’t really want to die. Why do I feel like this?”

Fortunately, I was able to sit and reflect on whether anything had changed recently and realized the Nasacort might be the problem. I didn’t see it in the lists of side effects online but found a few posts on forums where people shared similar experiences.

My mother-in-law is a therapist, so I called her up and shared what I was feeling and my suspicions. We made a plan for how I was going to handle the rest of the night and for her to call me back at bedtime and again in the morning. I called my husband and brought him up to speed, reassuring him that I was going to be ok because I knew the feelings weren’t mine. And then, following the plan, I asked a friend to spend several hours on the phone with me. I knew the feelings weren’t mine but I still felt them and didn’t want to be alone. We didn’t need to talk about how I was feeling. I’d explained the situation when asking for her help and she made sure that I wasn’t alone.

The next morning, I felt like I’d been through a good cry or a rainstorm.

By the next evening, I felt like a new person. Whether it doesn’t build up in the system or it had simply not built up yet, it was completely out of my body.

I was a little shaken, but my mental health immediately returned to normal.

It was a beautiful and wet summer, full of mushrooms.

–

As I said at the beginning, I generally haven’t shared this story because I don’t want to worry people–either about me or about a medication that seems to work great for most people. But the internet and search are becoming more and more unusable. I worry that chatbot systems, fed only on official side effect lists, may miss the more human stories. Forums are disappearing and people are deleting their twitter and reddit accounts. Back in 2018, finding those stories gave me hope and helped me plan to hang on until it was out of my system and I could know for sure. I want to put my own story into this messy system on the offchance it helps anyone recognize the same side effects.

If you’re experiencing a crisis of suicidal ideation, you may be able to get support by calling or texting 998. NPR has collected context on when and whether they’re likely to call the police, along with alternatives. If you suspect you’re dealing with a similar side effect, you may also benefit from doing what I did: making a safety plan with someone you trust and staying in contact with people as you wait for the medicine to leave your system. This state-by-state list of warmlines, which are for non-crisis situations, could be useful for finding a person to stay in contact with.