Prednisone Withdrawal Symptoms

Prednisone is a commonly prescribed steroid, which comes in the form of tablets, syrups, ointments and injections. It is used in the treatment of a number of ailments like arthritis, systemic lupus erythematosus, pneumonia, lymphoma, etc. The dosage of prednisone differs from person to person, depending on the type of infection present (either immune related or inflammatory) and its severity. But on the flip-side, this steroid also has many side-effects. Intake of prednisone cannot, and should not, be stopped suddenly. It has to be stopped step by step in a tapering manner, strictly under medical supervision, otherwise there might be adverse effects commonly known as prednisone withdrawal symptoms.

Mechanism of Prednisone

Corticosteroids, like prednisone, interfere with the actions of prostaglandins. Prostaglandins are naturally occurring fatty acids which produce the effects seen in response to trauma, thus, being responsible for inflammation and allergic reactions. However, sometimes corticosteroids interlope with the functioning of other systems such as the white blood cell function which causes some side-effects.

Side-effects of Prednisone

Side-effects of prednisone can be both short-term and long-term. Some of the prednisone side effects are as follows:

1. Weight Gain: Weight gain is the most common side-effect of prednisone. Fluid retention is the main culprit when it comes to weight gain. Another related prednisone side-effect is accumulation of extra fat in the body. This fat gets deposited in particular areas like the back, abdomen and face. The weight gained due to prednisone is lost after cessation of use of steroids.
2. Acne: Acne, commonly known as steroid acne, is one of the side effects of prednisone use. This acne may occur on the face, back or arms. However, chest is the most common area of outbreak. There are medications for curing this type of acne. Acne is not a long-term side effect. It decreases after dosage of prednisone is reduced
3. Susceptibility to infections: The immune system of a person becomes weak due to prolonged use of prednisone, due to which the body becomes more susceptible to internal and external infections.
4. Eyesight: Long term use of prednisone can affect the eyes. It tends to increase the pressure inside eyes which is known as glaucoma. Long term use of prednisone can lead to development of cataract. Unlike other side-effects of prednisone use, cataract does not reduce after the stoppage of prednisone.
5. Insomnia: Loss of sleep, which is known as insomnia is one of prednisones side-effects as well. Patients on prednisone for a long time find it difficult to sleep. But this side-effect of prednisone is not very common.

Symptoms

Withdrawal symptoms are the symptoms that arise if dosage of any drug is stopped abruptly. Withdrawal symptoms of prednisone are grave compared to other drugs, especially in case of long-term prednisone use. Once the usage of prednisone is started, the body slowly starts getting accustomed to it. The body starts depending on prednisone, so when prednisone is abruptly stopped, the body is left unaware and there is a sudden flare-up of the hitherto suppressed disease, for which the steroid was prescribed in the first place. This can be in three cases:

• Auto immune conditions: e.g. - arthritis, psoriasis, multiple sclerosis, scleroderma, etc.
• Severe allergic reactions: e.g. - Reaction to poison ivy, bee sting, shellfish, mold, etc.
• Serious inflammatory reactions: e.g. - inflammatory myopathies, shoulder tendinitis, gouty arthritis, etc.

Some other symptoms like weakness, headache, etc. are very common, and so can be overlooked.

• Weakness: Weakness and fatigue is the most common prednisone withdrawal symptom. One may feel extremely weak if prednisone is abruptly stopped. Muscle weakness is more prominent.
• Abdominal Pain: Frequent abdominal pain or a burning sensation is one of the withdrawal symptoms.
• Weight Loss: If prednisone is stopped abruptly, there is rapid weight loss which may lead to extreme fatigue. This is one of the most common prednisone withdrawal effects.
• Sudden dip in Blood Pressure: A person might experience a drop in blood pressure levels, even if one does not have low blood pressure.
• Joint Pain: This prednisone withdrawal symptom is more common with people who underwent prednisone treatment for arthritis. Joint pain may suddenly flare up.
• Menstrual Changes: There can be irregularity of periods in case of women.
• Nausea and Fainting: Nausea is one of the common symptoms. Nausea is considered as a serious withdrawal symptom. Prednisone withdrawal can also lead to symptoms such as fainting. If two or three of the above symptoms occur at a time, it is known as prednisone withdrawal syndrome. So it is necessary to taper prednisone and not stop it abruptly.

Thus, for prednisone withdrawal treatment, one should contact a doctor as soon as a few withdrawal symptoms are seen, to minimize risk of these symptoms escalating into full-blown secondary diseases or conditions.