White House aides fear Trump's medications have triggered manic behavior: report

Donald Trump
U.S. President Donald Trump participates in the first presidential debate against Democratic presidential candidate Joe Biden at the Case Western Reserve University Health Education campus in Cleveland, Ohio on September 29, 2020. Scott Olson / Getty Images
A stunning Thursday night report in the New York Times described how President Donald Trump appointed his enemies and called for prosecution to be brought against them, a tremendous violation of norms and a real and present danger to American democracy. Most shocking was the fact that this was largely not an anonymously procured bomb - most of the comments the Times report based on Trump were made public
But far down the report was a notable nugget about the White House that was not based on publicly available information. According to the Times reporters, Trump's own staff are concerned that his manic and erratic public behavior this week could be due to his illness and the medication he has been taking:
White House staff privately expressed concern over whether the president's buoyant mood in recent days was due to dexamethasone. Doctors who were not involved in the president's care said it could have a significant impact on a patient's behavior.
As I have reported, the President's public behavior since taking the steroid dexamethasone really seemed to be even more heightened and hectic than is typical for him. I have argued that there are several explanations for the President's temperament, none of which are particularly comforting.
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Unfortunately, the President's doctor, Dr. Sean Conley, proven completely unreliable about Trump's health. He has refused to answer many questions and has admitted to bypassing the truth to give an "optimistic" picture of the president's condition. However, the Times report suggested that experts and the members of the President highlight the possibility that the steroids could significantly alter his mood:
Dr. Negin Hajizadeh, a pulmonary / intensive care doctor at Northwell Health, found that the majority of Covid patients who receive dexamethasone are mechanically ventilated and are in an induced coma state so they have no behavioral side effects. However, large studies show that in general 28 to 30 percent of patients after steroid treatment have mild to moderate psychiatric side effects such as anxiety, insomnia, mania or delirium, and about 6 percent can develop psychosis.
“When we prescribe steroids, we warn our patients, 'This can make you feel nervous, or irritable,' said Dr Hajizadeh. 'We will tell family members, especially our elderly patients,' This can lead to insomnia, which can lead to changes in eating habits and, in extreme cases, mania and decision-making difficulties. '"
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It's hard to overstate how serious this is. In addition to the usual national security concerns that arise when the stability of the president's state of mind is called into question, he currently has the power to affect people's lives in a variety of ways. He is negotiating future plans for the debate over his Democratic opponent Joe Biden, trying to set up new campaign events while he is still contagious, and throwing into chaos discussions about a possible second stimulus package. The president is hardly a picture of stability under normal circumstances, but the prospect that drug-related mania could affect his decision-making at this point is unacceptable.
Because of this, many have argued that he should have invoked the 25th Amendment by now to transfer power to Vice President Mike Pence until it is clear that he has closed his case of COVID-19 and his duties are unhindered by the infection or whose treatment can fulfill. Given his conduct and the concerns reported by his own aides, it should be a much bigger thing that the president refused to give up control of his office.

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