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Prednisone is a corticosteroid, commonly called a steroid, that closely resembles the natural steroid hormone cortisol. It suppresses the body’s natural immune response to reduce inflammation, arthritis pain and the effects of a range of conditions. It’s prescribed to treat or lessen the discomfort associated with allergies, autoimmune disorders, cancer and more.
When an individual takes prednisone for an extended period of time, their body starts to become accustomed to the increased levels of cortisol. This means that when they stop taking prednisone, their body experiences a sudden drop in cortisol and is unprepared to regulate various processes at this lower level.
Suddenly going off of prednisone can potentially cause uncomfortable withdrawal symptoms. Knowing what to expect from these symptoms and identifying strategies for avoiding them can help individuals prevent complications
Understanding Prednisone Withdrawal Syndrome
Prednisone Withdrawal Syndrome often brings uncomfortable symptoms, making it difficult for some to stop taking the medication. Understanding the causes, symptoms and risk factors of PWS can help individuals manage the transition off this medication safely.
What is Prednisone Withdrawal Syndrome?
As is the case with most medications, the longer someone takes prednisone, the harder it is for their body to adjust to not having it. Due to the chronic nature of the conditions this medication is prescribed for, it’s fairly common for individuals to take prednisone for an extended period of time. When this happens, the body starts to become accustomed to the increased levels of cortisol. This means that when the user stops taking prednisone, the body experiences a sudden drop in cortisol and is unprepared to regulate various processes at this lower level.
Some of the most common withdrawal symptoms include:
- Mood instability
- Weakness
- Severe fatigue
- Body aches and joint pain
- Dizziness
- Light-headedness
- Appetite fluctuations
- Nausea and vomiting
In most cases, these prednisone withdrawal symptoms last one to two days after stopping prednisone, but they can be alarming if you’re not expecting them. And, when your body is out of rhythm, it can have a larger effect on your physical and mental health than you may realize.
How Long Do Prednisone Withdrawal Symptoms Last?
The duration of withdrawal symptoms depends on many things, like how long you were taking the steroid and the strength of the dose. However, experiencing mild to moderate physical symptoms for 1 to 2 weeks as you taper off the medication is average. During this period, it’s important to refrain from any other medications (including over-the-counter pain meds) unless you’ve received a doctor’s approval first.
On the other hand, psychological symptoms can persist for up to 2 months. If the psychological withdrawal symptoms are severe, your doctor may decide to taper you off prednisone more slowly. You may also receive blood tests to test your cortisol levels during this process. Regardless of the type of symptom, you should keep your doctor informed on how you feel so they know how to help you best.
Causes of Prednisone Withdrawal
The causes of prednisone withdrawal symptoms lie in the way the body responds to the medication. Under normal circumstances, cortisol regulates itself without the influence of medication. It assists in the body’s natural processes, like controlling stress and keeping the heart rate steady.
With the influence of prednisone, the increase in cortisol works to suppress the body’s immune response. When the drug works as intended, this lowers inflammation and other side effects of the body being attacked by its own immune system.
If you suddenly stop taking prednisone, your body doesn’t have the time it needs to adjust to the absence of the medication. This causes a deficiency in cortisol, leading to withdrawal symptoms.
Risk Factors for Developing PWS
An individual’s dosage and the duration of prednisone therapy are the biggest predictors of whether they’ll experience withdrawal symptoms. The more they took, and the longer their body has depended on this medication, the more likely they are to experience discomfort when they stop taking prednisone.
Strategies to Avoid Prednisone Withdrawal Syndrome
While PWS may not be entirely avoidable, especially if you’ve taken prednisone for an extended period of time, some strategies can help you manage any discomfort you experience.
Pre-Tapering Consideration
Before making any changes to your medication, have a discussion with your doctor about a personalized tapering plan. This gives your doctor the opportunity to review your medical history, including the dose and duration of prednisone use, as well as any other medications you’re taking.
As you begin the process of stopping prednisone, it can be helpful to set up a support system that can assist you in navigating withdrawal and recurring symptoms of allergies or autoimmune disorders.
Professional counseling provides someone to talk to who can reassure you that you’re not alone in your struggles. A counselor can also provide you with tips and strategies to help you overcome the mental aspect of prednisone withdrawal. However, talking to a trusted friend or family member is also beneficial if you can’t afford professional counseling (or don’t have the time for it).
Monitoring During Tapering
As you’re tapering off prednisone, tracking your symptoms in a diary can help you track the duration and intensity of symptoms. This can help you recognize the withdrawal side effects you’re experiencing and notice changes in severity.
Additionally, it’s important to keep regular follow-up appointments with your health care provider. Most people won’t start taking a new medication without a doctor’s advice, diagnosis, or treatment guidance, but fewer people know this works the same way when stopping medications. Drugs change the way our bodies and brains function, so it’s important to remove these influences under medical supervision. Your doctor can help you taper off prednisone gradually, reducing the potential for withdrawal symptoms.
Can Tapering This Medication Cause a Flare?
If you taper corticosteroids as your doctor prescribes, you shouldn’t have a flare or experience severe prednisone withdrawal symptoms. What may be happening instead is that your inflammation is returning. Speak with your doctor about what to do. They’ll most likely recommend a brief period of higher steroids to get the inflammation under control before having you taper back off the medication.
Lifestyle Adjustments to Support Recovery
Incorporating a few lifestyle adjustments can help you reduce uncomfortable symptoms throughout the recovery process.
Nutrition and Hydration
A healthy body and mind can better manage symptoms and potentially speed up the withdrawal process. Remember to stay hydrated and eat a healthy, well-balanced diet. Avoid sugar, simple carbohydrates and excess oils or fats. If you do indulge in these, do so in moderation.
Exercise and Stress Management Techniques
Prednisone withdrawal can cause aches and pains. Gentle exercises can help reduce these symptoms. Consider taking a leisurely walk around the block a few times when you’re aching. Gentle yoga can help stretch out tight muscles that could contribute to muscle pain. Warm-water pool exercises are always an excellent option to get moving while taking some pressure off your joints and muscles.
Although exercise can help manage prednisone withdrawal, you should be careful not to overdo it — especially if you’ve been sedentary for a while.
Potential Use of Alternative Therapies
Meditation may help calm any anxiety you’re experiencing as part of your withdrawal. The deep breathing exercises taught in meditation are especially useful, as they can help regulate your heart rate and “trick” your body out of feeling anxious. Another benefit of meditation is mindfulness and centering your mind.
Along with this, many people find that aromatherapy with lavender or chamomile essential oils promotes relaxation and reduces anxiety while tapering off prednisone. Others find relief with massage therapy, which aids in relieving muscle tension.
When to Seek Medical Attention
In most cases, prednisone withdrawal symptoms are mild and easy to manage with adequate rest and lifestyle adjustments. In rare cases, individuals may experience more significant symptoms that require medical attention.
Recognizing Severe Withdrawal Symptoms
While severe prednisone withdrawal symptoms are unusual, they do occur and may require intervention from a doctor. Some signs to watch for include:
- Extreme tiredness
- Significant mood changes, including feelings of depression or anxiety
- Muscle weakness
- Nausea or vomiting
- Fever
- Low blood pressure
- Confusion
- Loss of appetite
- Severe headaches
- Joint pain
Importance Of Professional Guidance
If you taper corticosteroids as your doctor prescribes, you shouldn’t have a flare or experience severe prednisone withdrawal symptoms. What may be happening instead is that your inflammation is returning. Speak with your doctor about what to do. They’ll most likely recommend a brief period of higher steroids to get the inflammation under control before having you taper back off the medication.
Does Your Body Go Back to Normal After Prednisone?
It may take some time for you to feel “normal” after tapering off prednisone — especially if you’ve been taking it for a long time. It’s normal to wonder, “Does your body go back to normal after prednisone?” But, thankfully, the answer is a resounding, “Yes.” The most important thing is to give your body and mind time to adjust after tapering off of prednisone.
How Do You Prevent Prednisone Withdrawal?
There are some ways to prevent prednisone withdrawal from occurring in the first place:
1. Follow your doctor’s instructions any time you’re starting or stopping a medication.
Most people won’t start taking a new medication without a doctor’s advice, diagnosis, or treatment guidance, but fewer people know this works the same way when stopping medications. Drugs change the way our bodies and brains function, so it’s important to remove these influences under medical supervision. Your doctor can help you taper off prednisone gradually, reducing the potential for withdrawal symptoms.
2. Stay on the medication only as long as you need to.
Dependence on drugs with lower abuse rates takes time to develop. Most experts recommend stopping prednisone long before this has a chance to occur. According to one site focused on prednisone for inflammatory bowel disease, “Steroids should ideally only be used for a short period of time to get over a flare-up or while long-term treatments become established.”
Are Dependence/Addiction Possible with Prednisone?
Drugs like prednisone aren’t intended for long-term use and may become dangerous when used for longer than recommended by medical professionals. “Addiction” to prednisone isn’t a concern. However, when your body becomes dependent on a certain level of cortisol, it can feel as though you need the drug to function. This means that even if you’re using it for the right reasons, prednisone provides a benefit that may become difficult to give up.
In other words, even if drugs like cortisol are less acutely dangerous than more addictive substances, there’s still the potential for dependence issues. Experts call addiction/dependence to corticosteroids “an unusual, but potentially serious complication of corticosteroid use.”
How Does Prednisone Work?
Under normal circumstances, cortisol regulates itself without the influence of medication. It assists in the body’s natural processes, like controlling stress and keeping the heart rate steady.
With the influence of prednisone, the increase in cortisol works to suppress the body’s immune response. When the drug works as intended, this lowers inflammation and other side effects of the body being attacked by its own immune system.
Conclusion
Prednisone withdrawal symptoms can be uncomfortable, but they’re rarely dangerous. Tapering off the medication slowly under the supervision of a doctor reduces the risk of severe side effects, and incorporating some lifestyle modifications, such as exercise and adequate nutrition, can further support a smoother transition.
While addiction or dependence on prednisone is rare, it happens, and like all addictions, it doesn’t discriminate. Anyone can be affected by it.
If you or a loved one find yourself in a cycle of addiction or dependence, FHE Health offers support and a safe place to get clean. Contact us today to learn how we can help.
