Prednisone is a steroid-type drug. When a person stops taking prednisone or other steroids abruptly, they may notice symptoms similar to adrenal insufficiency. These include lethargy, low appetite, weight loss, and a general feeling of being unwell.
Prednisone is a corticosteroid that doctors prescribe to treat swelling and inflammation. It relieves swelling, itching, and redness by suppressing the immune system.
Doctors should prescribe the lowest possible dose of prednisone to meet a person’s health needs. This is because of the risk of adverse effects.
When a person needs to stop taking prednisone, a doctor will recommend doing so gradually to prevent withdrawal symptoms.
In this article, learn the withdrawal symptoms of prednisone, why they happen, and how to prevent them.
Prednisone is a glucocorticoid, which is a synthetic steroid similar to cortisol, a hormone that the adrenal glands produce. Some people refer to cortisol as the stress hormone.
However, cortisol does much more than manage stress. The body also uses cortisol to regulate the heart rate and blood pressure.
Without medication, the body naturally maintains a consistent level of cortisol.
However, when a person takes prednisone, particularly when the course of treatment lasts for more than a few weeks, the body will reduce the amount of cortisol it makes.
When a person stops taking prednisone, the body cannot immediately produce enough cortisol to make up for the missing drug. It may take several days or weeks before the body’s cortisol production levels return to normal.
While the adrenal glands make most of the body’s cortisol, many different types of cells in the body have cortisol receptors.
As a result, the body uses cortisol for many functions,
- mediating the stress response
- regulating metabolism
- managing inflammation
- mediating the immune response
- managing the levels of blood sugar reaching the brain
- reducing insulin and increasing glucagon levels in the pancreas
When the body is not producing enough cortisol to compensate for the missing prednisone, a person can experience a range of symptoms while the body readjusts. This is known as adrenal insufficiency.
People who stop using prednisone after a long time may experience symptoms of corticosteroid withdrawal syndrome, such as:
- body aches
- joint pain
- a general feeling of being unwell
- weight loss
- fatigue
- low blood pressure
darkening of skin color- changes in mood
In some older studies, researchers noted the occurrence of:
- headaches
- nausea and vomiting
- inflammation
- fever
Symptoms can vary in intensity and may last anywhere from a few days to several months after discontinuing the drug.
The severity and duration of withdrawal symptoms usually correlate with the length of time a person was taking prednisone and the size of their regular dose.
People who are using prednisone should check with a doctor before stopping or reducing their dose.
Anyone experiencing symptoms of prednisone withdrawal after reducing the dose or stopping the medication should consult a doctor.
The doctor may adjust the taper schedule and recommend ways to manage the withdrawal symptoms.
Treatment for prednisone withdrawal focuses on managing the symptoms and controlling the body’s cortisol production.
Some lifestyle choices that can help manage prednisone withdrawal symptoms include:
- getting enough sleep
- using strategies to manage stress
- avoiding or limiting caffeine and alcohol
- eating a varied and nutritious diet
In some cases, these lifestyle approaches may not be enough to help a person with severe symptoms.
People who have severe symptoms while stopping prednisone should consult a doctor immediately. The doctor may need to readjust the tapering plan or treat any health complications.
To help prevent prednisone withdrawal, a person can take the following precautions while using prednisone and during the taper period afterward:
- sticking to the recommended dosage and not taking more than the doctor prescribes
- tapering the dose according to the doctor’s instructions
- avoiding suddenly stopping prednisone treatment
Doctors prescribe prednisone for numerous conditions, including:
- endocrine disorders that lead to low cortisone levels
- rheumatoid arthritis and other types of arthritis
- diseases that affect collagen, such as systemic lupus erythematosus (SLE) or lupus
- severe allergies and asthma
- some skin conditions, such as severe psoriasis
- eye problems, for example, allergic conjunctivitis
- some respiratory diseases
- some blood disorders, for example, acquired hemolytic anemia
- severe flares of some chronic gastrointestinal diseases
- multiple sclerosis flares
- leukemia
- some types of edema, or fluid retention
When doctors prescribe prednisone, they will generally specify a dosage that gradually decreases over several days to prevent prednisone withdrawal. They will usually not prescribe prednisone or other corticosteroids for long-term use, as the drugs can have severe adverse effects.
In most cases of steroid withdrawal, symptoms are self-limiting and will resolve with time. Most people recover fully from prednisone withdrawal once their body begins producing enough cortisol again.
The duration of symptomatic withdrawal will vary according to the dosage of prednisone the person was taking and the length of treatment.
Generally, those on a lower dose for a shorter period will have less severe symptoms. They may also recover from prednisone withdrawal more quickly, or they may not experience any withdrawal symptoms.