What is prednisone?
Prednisone is a man-made steroid (a corticosteroid) that differs from anabolic steroids that are typically used by athletes and bodybuilders to build up their muscle mass. The cortisol hormone is produced by the adrenal glands (two small glands located near the kidneys) in response to stress and inflammation in the body.
Cortisol is a small signal molecule in the body called a hormone that tells different body parts what they should do. When hormones enter the blood, the body reads and interprets the hormone messages, and acts appropriately.
While not all steroids are hormones and vice a versa, prednisone is both a hormone and steroid. It has the molecular structure of steroids and transmits messages to different body parts in much the same way as a hormone.
It is a synthetic hormone that mimics natural cortisol but is four times more potent than cortisol.
What is prednisone used for?
It suppresses your immune system and decreases inflammation. It is typically used to treat allergic, autoimmune, and inflammatory conditions such as:
- Cute asthma
- Rheumatoid arthritis
- Psoriatic arthritis
- Ulcerative colitis
- Multiple sclerosis
- Severe allergic reactions
- Crohn’s disease
- Autoimmune hepatitis
- Chronic obstructive pulmonary disease
It treats these conditions by reducing the inflammation that causes them.
Additional uses include the treatment of skin, kidney, endocrine, gastrointestinal, bone marrow, eye, and vision problems. The hormone is taken orally, but other steroids may be injected.
Side effects of prednisone
The common side effects of taking prednisone include the following:
- Appetite changes
- Vomiting and nausea
- Reddening of skin
- Weight gain
- Face puffiness
- Mood swings
- Stomach discomfort
- Retention of fluid and sodium
- Male pattern hair growth in women
- Inappropriate happiness
- Decreased libido
- Bulging eyes
Serious but rare side effects and side effects that appear with long term use include the following:
- Muscle problems
- Insufficient adrenal gland function
Addiction and withdrawal of prednisone
It does not create a high, so it does not have addictive potential. Dependence on the steroids can develop, and withdrawal symptoms are experienced when the drug is stopped.
Prednisone use should always be followed as directed by a doctor. If a dosage is missed for one or two days, it will not trigger the onset of withdrawal symptoms. However, if a person waits any longer, withdrawal symptoms may occur.
Withdrawal from the steroid may be a very uncomfortable experience, but it is not deadly. Because the steroid mimics cortisol in the body, when prednisone is taken, the body reduces the amount of cortisol it produces a few weeks after the introduction of prednisone.
After a person dependent on prednisone, stops taking the steroid, the body continues producing less than normal levels of cortisol. The body takes many days to adjust to the reduction of prednisone, and as a result, it may display prednisone withdrawal.
The typical prednisone dosage for the treatment ranges from 5 to 60 mg per day. Standard tablet sizes used are 5 mg, 10 mg, and 20 mg. The dosages prescribed depend on:
- The condition prednisone will treat
- If prednisone was previously used
- How long it was already used for
- Possible drug interactions
The dosage of prednisone may be adjusted by the prescribing doctor based on the patient’s response to the medication. A “cold turkey” approach to stopping the use of prednisone is not recommended. When the medication must be discontinued, it is gradually decreased to reduce or prevent withdrawal symptoms.
If the steroid is taken for more than a few weeks, the adrenal glands will reduce its cortisone production. Gradually reducing the dosage of prednisone allows the body to increase its cortisol production back to the average level.
When cortisol is drastically reduced or stopped, the patient may experience withdrawal symptoms such as:
- Decreased appetite
- Joint pain
- Extreme fatigue
These withdrawal symptoms eventually resolve on their own when tapering methods are followed. Some of these withdrawal symptoms, such as fatigue, dizziness may result in dangerous situations such as when driving.
The manner in which prednisone dosage is reduced depends on what was being treated, the dosage that was given, how often, how long, and how much, as well as other medical factors.
Prednisone withdrawal methods
The typical method to treat prednisone withdrawals is referred to as steroid withdrawal syndrome (SWS). In this process, either an increased dosage is given, or the dosage is tapered down.
Tapering methods may last from a few days to a few weeks, depending on the dosage of prednisone used and the length of time it was taken. Most regiments longer than five days need to be tapered.
If a patient experienced withdrawal symptoms after taking 20 mg for five days, followed by a reduced dosage of 10 mg, the doctor could follow either of two courses of action:
- Re-establish the dosage of 20 mg for a few days
- Increase the dosage to 15 mg then decreasing it to 10 mg
Detox from the steroid is not needed as long as the patient follows the advice of his doctor. The steroid exits the body within 24 hours, but its effect on the body may last for several days following.
When the prednisone patient undergoes withdrawal in the hospital, he is carefully monitored and should experience no withdrawal symptoms.
An individual undergoing the tapering process at home should be sure to follow his prescription guidelines very carefully. If despite this, he experiences withdrawal, he should contact his doctor for a consultation.
Helpful prednisone withdrawal tips
The following points should be followed by patience undergoing prednisone withdrawal:
- Consult with a medical professional regarding symptoms and possible withdrawal risks
- Get an adequate amount of sleep daily
- Eat healthy meals
- Exercise as normal
- Be aware that withdrawal symptoms are only temporary and will soon pass
Treatment and Rehab
Prednisone is not an addictive medication, and as such, withdrawals from the steroid are not treated at a rehab or addiction center. Withdrawal and physical dependence on the steroid will develop if it is used for more than five days.
When such symptoms develop patient should contact an urgent care clinic or go to his doctor. A patient may experience distressing withdrawal symptoms if he takes his tapering medication incorrectly or forgets to pick up his prescription.
If this occurs, the patient should consult his doctor, who will help by correcting with additional prednisone prescription.