Published in NJ Heart and Lung News
Doctors prescribe prednisone, a corticosteroid, to treat a variety of conditions that involve swelling and inflammation. These conditions include breathing difficulties such as asthma; skin conditions that cause swelling and itching, such as poison ivy; arthritis; allergies; digestive problems; kidney problems; multiple sclerosis (MS) episodes; and lupus.
Although, prednisone is generally prescribed for short-term use, the dose is usually reduced slowly over several days. This is because if prednisone therapy is stopped abruptly, the patient may experience prednisone withdrawal.
Symptoms of prednisone withdrawal include nausea, severe fatigue, weakness, loss of appetite, lightheadedness, weakness, joint pain, mood swings, and body aches.
The longer the prescribed course of prednisone, and the higher the dose, the more severe withdrawal symptoms would be, and the longer they would last.
Given the risks of prednisone withdrawal, why would anyone stop prednisone abruptly? We see the same thing happen with people who are prescribed antibiotics. Just 24 hours on antibiotics can make someone with a bacterial infection feel much better. So, too, one day of prednisone can greatly alleviate the symptoms of the condition for which it was prescribed.
But simply feeling relief from symptoms is not the same as being well and no longer requiring medication. In the case of antibiotics, the infection has not yet been eradicated; in fact, stopping a course of antibiotics in the middle can cause it to return with extra strength — and often resistant to the original antibiotic. With prednisone, the body’s hormonal system — in particular, the adrenal gland — is disrupted when taking the drug, and it takes to return to normal. Until it does, the person still needs prednisone, though in ever-smaller quantities.
What is the best way to avoid prednisone withdrawal? Follow your doctor’s instructions to the letter. The dosages, including the tapered dosages, are prescribed in a way to make the weaning process go smoothly. A person on prednisone should never stop their course of treatment suddenly. They should also not take more medication than prescribed, or alter the schedule of tapered doses.
In addition, when being weaning off prednisone, it can be helpful to make certain lifestyle changes to help ease the return to normal adrenal function. These changes include abstaining from alcohol and caffeine, getting enough sleep, and avoiding stress.
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