Will dexamethasone give you energy? Understanding the complex effects on energy levels

October 8, 2025 •

4 min read

Research from institutions like MD Anderson Cancer Center has shown that for some patients, a short course of dexamethasone can help alleviate cancer-related fatigue and boost energy levels. However, the question, will dexamethasone give you energy?, has a complex answer depending on dosage, duration, and individual health.

Quick Summary

Dexamethasone can cause an initial, temporary increase in energy or hyperactivity in some individuals, sometimes used to combat cancer-related fatigue. However, this effect often wanes, and prolonged use can lead to chronic fatigue, muscle weakness, and sleep disturbances like insomnia, ultimately causing daytime tiredness.

Key Points

Temporary Energy Increase: Some individuals may experience a short-term energy boost or hyperactivity when starting dexamethasone.
Fatigue in Long-Term Use: Prolonged use of the medication frequently leads to chronic fatigue and muscle weakness (myopathy).
Insomnia is a Common Side Effect: Dexamethasone can disrupt sleep patterns, causing insomnia and restlessness, which contribute to daytime fatigue.
Energy Wanes Over Time: The initial 'burst' of energy is temporary and tends to decrease as the body adjusts to the medication.
Withdrawal Symptoms Include Fatigue: Abruptly stopping dexamethasone, particularly after high or prolonged doses, can cause a rebound effect of severe tiredness and weakness.
Used in Palliative Care: Short-term dexamethasone is sometimes utilized to temporarily combat severe cancer-related fatigue, often combined with exercise.

The Dual Effect: Initial Energy Boost and Long-Term Fatigue

Dexamethasone is a potent corticosteroid used to treat a wide range of conditions, from severe inflammation to certain types of cancer and allergic reactions. Its effects on the body are powerful and can influence energy levels in different, sometimes contradictory, ways. In the short term, many patients report a temporary surge of energy, while others experience the opposite over time, with cumulative fatigue and weakness becoming a significant side effect.

Short-Term Effects: The Initial 'Burst'

For many patients, especially those starting treatment, dexamethasone can cause an initial feeling of increased energy and even hyperactivity. This effect is not the primary purpose of the medication but is a common side effect of corticosteroids due to their systemic impact on various body functions. It is thought to be related to the drug's anti-inflammatory properties, which can reduce the systemic inflammation that often contributes to disease-related fatigue. In palliative care settings, a short course of dexamethasone is sometimes specifically prescribed to alleviate severe fatigue in patients with advanced cancer. This can provide a temporary boost that allows patients to achieve short-term goals, such as attending a special event. The energy increase is often accompanied by other effects, such as a change in mood, which can include feeling abnormally well or euphoric. It is crucial to understand that this is typically a short-lived effect and not a reliable, sustained outcome of treatment.

Long-Term Effects: The 'Waning' Effect and Cumulative Fatigue

As treatment with dexamethasone continues, the initial energy boost often wanes, and a different set of side effects can emerge. Prolonged use of corticosteroids is associated with a risk of adrenal insufficiency, where the body's natural production of cortisol is suppressed. When this happens, a person can experience a lack of energy, weakness, and other symptoms. Long-term steroid therapy also increases the risk of muscle problems, including pain and weakness (myopathy), which can lead to a significant decrease in a person's overall energy levels. Animal studies have even suggested that long-term dexamethasone treatment can reduce energy expenditure. Therefore, while the initial days might feel energizing, the cumulative effect of long-term use is more likely to result in fatigue and decreased physical stamina.

How Dexamethasone Impacts Sleep and Metabolism

Beyond its direct effects on energy, dexamethasone significantly impacts the body in ways that can affect rest and metabolic function.

Insomnia and Sleep Disturbance

One of the most commonly reported side effects of dexamethasone is insomnia, or difficulty sleeping. The drug can cause restlessness and increased alertness, which disrupts the natural sleep-wake cycle. In children with acute lymphoblastic leukemia, studies have confirmed that dexamethasone adversely alters sleep and fatigue. The resulting poor sleep quality leads to significant daytime tiredness and fatigue, which can easily overshadow any temporary energy boost. To minimize sleep disruption, healthcare professionals often advise taking dexamethasone in the morning.

Metabolic Changes

Corticosteroids like dexamethasone can affect how the body processes sugar, often leading to increased blood sugar levels (hyperglycemia). This can be a significant concern for individuals with diabetes. These metabolic changes can also influence how the body acquires and stores energy, potentially contributing to feelings of fatigue or unusual weight gain.

Dexamethasone and Energy Comparison: Short-Term vs. Long-Term


Feature	Short-Term Dexamethasone Use	Long-Term Dexamethasone Use
Effect on Energy	Often results in a temporary increase in energy, vitality, or hyperactivity.	Can lead to chronic fatigue, muscle weakness (myopathy), and reduced energy.
Effect on Sleep	Can cause insomnia, restlessness, and disturbed sleep patterns.	Long-term use can continue to disrupt sleep, leading to cumulative sleep debt and daytime fatigue.
Underlying Mechanism	Reduction of inflammation and systemic effects of corticosteroids.	Suppression of the adrenal gland and potential muscle-related issues.
Duration	The energy boost is typically short-lived and tapers off over time.	Associated with prolonged therapy, the effects of which can persist.
Associated Condition	Used to combat cancer-related fatigue or other acute inflammatory conditions.	Related to the chronic management of conditions requiring long-term steroid therapy.

The 'Rebound' Effect: Fatigue After Stopping

If a person has been taking dexamethasone for an extended period, it is crucial not to stop the medication abruptly. The body's adrenal glands, which naturally produce cortisol, may have become suppressed. A sudden cessation can cause a withdrawal effect known as adrenal insufficiency, with symptoms including severe tiredness, weakness, body aches, and joint pain. A healthcare provider will guide the patient through a tapering schedule to allow the adrenal glands to recover gradually.

Conclusion: Context is Key

In summary, the answer to the question "Will dexamethasone give you energy?" is not a simple yes or no. The experience is highly dependent on the individual, the dosage, and the duration of use. While a temporary energy boost is a known, though unintended, side effect, relying on dexamethasone for sustained energy is not only ineffective but also carries significant risks. Chronic fatigue, muscle weakness, and sleep disturbances are more likely outcomes with long-term use. For any concerns regarding fatigue or the use of dexamethasone, it is essential to consult with a healthcare professional for proper evaluation and management.

Key Takeaways for Dexamethasone and Energy

Short-term energy boost: Dexamethasone can cause a temporary, initial increase in energy and mood in some individuals.
Not for chronic fatigue: Using dexamethasone for long-term energy is unsafe and ineffective, and it can eventually lead to worsening fatigue and muscle weakness.
Insomnia is common: Sleep disruption is a frequent side effect, leading to daytime tiredness and canceling out any perceived energy benefit.
Risk of withdrawal fatigue: Abruptly stopping the medication can cause severe fatigue and weakness as part of a withdrawal syndrome.
Always follow medical advice: The use of dexamethasone should always be under the supervision of a healthcare provider, especially regarding dosage, duration, and discontinuation.

Frequently Asked Questions

Yes, dexamethasone can cause both. Initially, some people feel a temporary energy boost or hyperactivity. However, this often subsides, and with continued or long-term use, it can cause chronic fatigue, muscle weakness, and insomnia, leading to overall low energy.

No, long-term use of dexamethasone is not recommended for chronic fatigue syndrome or general fatigue due to its significant side effect profile. While it may provide a temporary lift, the risks, including increased fatigue and muscle weakness over time, outweigh the potential benefits.

To help with dexamethasone-induced sleep problems, try taking the medication in the morning to align with your body's natural rhythm. Maintaining a healthy sleep routine, ensuring a dark and quiet sleep environment, and avoiding large meals or caffeine before bed can also help.

Dexamethasone is not a performance-enhancing drug and is banned in-competition for athletes. In fact, chronic use can weaken muscles and decrease athletic performance. It is sometimes restricted because it can mask an underlying injury, putting the athlete at greater risk.

If you have been on dexamethasone for an extended period, abruptly stopping can cause serious withdrawal symptoms, including severe tiredness, weakness, body aches, and joint pain. It is crucial to always follow a doctor's tapering schedule to allow your adrenal glands to recover safely.

The "crash" refers to the severe fatigue, weakness, and overall feeling of being unwell that can occur if the medication is stopped too quickly. This is due to adrenal suppression, where the body relies on the medication and does not produce enough of its own corticosteroids.

The initial energy surge is typically temporary and often wanes as treatment continues. There is no set timeframe, as it depends on the individual's response, dosage, and duration of therapy. After the initial period, cumulative fatigue or side effects are more likely.