Corticosteroids are a group of drugs that reduce inflammation and pain, moderate the immune system, treat certain cancers and help the body during times of stress. One commonly prescribed corticosteroid is prednisone.
Prednisone is usually taken as a pill, but it can also be given via an injection into a muscle or vein. If prednisone is taken longer than for one week, the body can become dependent upon this external source of corticosteroid. Prednisone taken orally can cause many side effects. Most of these side effects occur after long-term use. Prednisone treatment is gradually withdrawn under medical supervision.
If a person suddenly discontinues the use of prednisone he can go into shock. The adrenal glands decrease production of natural corticosteroids when oral prednisone is taken. This suppression is directly related to the dose of the prednisone--the higher the dose the more likely the adrenal glands have been suppressed. Other signs of prednisone withdrawal include headache, dizziness or lightheadedness when standing, body aches, headache, severe fatigue and nausea.
Doctors balance the need for prednisone treatment with the likely effect of adrenal suppression. Many times a large dose of prednisone will be taken on the first day of treatment followed by decreasing doses spread over a number of days. Another alternative is to take prednisone on an every other day basis. Any use of prednisone or tapering dosages should only be done under the direction of a doctor. If any withdrawal symptoms are noticed during the withdrawal period, contact your doctor.
If a person does have prednisone withdrawal symptoms, the doctor will carefully examine the patient for concurrent illness and ask about stress. Some patients will have a physiological need for steroids because of the suppression of the adrenals. Other withdrawal symptoms may indicate a flareup of the disease that made steroid use necessary. In either case, the prednisone dose may need to be increased and withdrawal attempted at a later date or over a longer period of time.
People on long-term prednisone therapy will need to balance the side effects associated with prednisone use with the benefit of treatment for their health condition. Many times the starting dose of prednisone for these individuals will be a large dose, 40 milligrams or more, daily. If a large dose is needed to suppress disease activity, the tapering schedule will consist of reducing the dose by 5 to 10 mgs every few weeks. This is done until the lowest dose possible is obtained to control the disease. It may take as long as three months to withdraw from prednisone.