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Withdrawal Symptoms

Posted , 4 users are following.

Fandango
Fandango

Has anyone experienced withdrawal symptoms from reducing from 20mg Prednisolone daily to 17 and a half mg.  I reduced 5 days ago and have headaches, sore muscles in arms and the palpitations which I felt had subsided have come back.  Could this be due to the slightly reduced dose?  

0 likes, 10 replies

10 Replies

  • ptolemy
    ptolemy Fandango

    Posted

    I had terrible trouble reducing from 20mg to 17.5mg. In the end I took the old dose one day and the new dose the next which made it easier. 
    • Fandango
      Fandango ptolemy

      Posted

      Thanks for your reply Ptolemy.  What were your withdrawal symptoms?  I am concerned that the Temporal Arteritis will return and the symptoms I have just now are very like TA.  However I am aware that withdrawal symptoms occur when the dosage reduces. It is difficult to know what is going on.  What dose are you on now?
    • ptolemy
      ptolemy Fandango

      Posted

      I am on 9mg now. I reduce much more slowly now having learnt my lesson. When I reduced too quickly, I felt like death, I did not know what to do with myself, I felt incredibly tired and ached all over. 
  • anapp
    anapp Fandango

    Posted

    I have had withdrawal symptoms every time I reduced all the way from 60 down for GCA.  I have extreme fatigue and malaise and got the headaches a few times so went back up several time and usually had to stay on the old dose for another month. Sometimes I took an extra mg. one day and back to reg. doses the next.  I'm down to 1mg every other day now but have the extreme fatigue still and feel like I'm getting my PMR back. May go back to 1mg every day or wait til I see Dr.   Don't know of anyone fortunate enough not to have withdrawal symptoms..  
  • EileenH
    EileenH Fandango

    Posted

    If it happened as soon as you reduced the dose it is likely to be the effects of steroid withdrawal - some patients are very sensitive to change in dose. If it improves over the next few days or up to a couple of weeks altogether there is no need to worry but if the pain gets worse it is a sign that the dose is too low to manage the symptoms of the current level of activity of the autoimmune cause of the PMR.

    If you reduce either in far smaller steps or using the "Dead slow and nearly stop" approach we oftn talk about on the forum you will probably eliminate the withdrawal symptoms - I have none at all doing it that way. No reduction should be above 10% of the current dose, that has been accepted by US experts for a long time. For some, even that is too much and spreading the reduction over a longer period helps a lot.Alternating old/new as ptolemy described is a half-way house and works for many people. 

    • Fandango
      Fandango EileenH

      Posted

      Thank you, Eileen.    My rheumatologist told me to reduce by two and a half mg a month from 20mg to 10mg  and from 10mg he said that I would reduce by 1mg a month or every 2 months depending on how it goes.   I have temporal arteritis. Still have the headaches and hoping they will calm down soon.
    • ptolemy
      ptolemy Fandango

      Posted

      Under 10mg I would go for the 1mg every two months max. I think your rheumie may be optimistic about your reductions above 10mg, some people can reduce more easily than others, but even then I think it may be rather an over enthusiastic reduction. 
    • EileenH
      EileenH Fandango

      Posted

      As ptolemy says - optimistic rheumies will say you can reduce to a plan and at their speed. Unfortunately the PMR doesn't usually listen to the conversation and doesn't play the same game. You can only reduce in line with your symptoms - not the rheumy's ideal.
  • Fandango
    Fandango

    Posted

    Thank you Ptolemy and Eileen.  I will see how it goes.  I certainly felt bad dropping from 20mg to 17 and a half - headaches and various other aches and generally unwell.  Feel a bit better today - now 9th day on 17 and a half. 
    • EileenH
      EileenH Fandango

      Posted

      If you are starting to feel better that does suggest that there may have been an element of steroid withdrawal there - the body doesn't like having its fix removed! Next time try 1mg at a time, even alternating old and new dose for a few days.
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