Hey all,
Since I was diagnosed with RA I was given 15mg methotrexate and 400mg Hydroxy, and Cortisone 120mg.
I have had 3 of these injections over 3 months and felt great, now im not needing them for pain I feel like I need them mentally.
Has any one here felt like they have had withdrawal symptoms from stopping steroids?
Thanks,
Adrian.
Not from injections Adrian but of course we have to be careful when we taper oral steroids so don't see why it should be any different for injections, dependency wise. Dependency isn't unknown as this c&p'd from the NHS choices site under the heading Corticosteroids - side effects, subsection Injected Corticosteroids says
"You may also experience mood changes. For example, you could go from feeling very happy one minute to being irritable, depressed or restless the next."
You'll find the full text here if you wish to read on nhs.uk/Conditions/Corticost...
I have generally only been prescribed oral deflazacort & remain on low dose because when I've tried to taper them my symptoms return.
Three injections over as many months does seem a lot, unless they were small doses each time in differing areas. As I understand it they're careful how many are given as it can cause tissue damage if repeatedly given in one place.
It might be an idea to have a word with your nurse specialist who should be able to give your the proper advice on whether you've become dependent on them & the best way forward for you.
Hope this helps.
I've never had injections so close together - at the start I had one every couple of months, and now maybe one a year if I'm having a bad patch. But they certainly did more for me than just pain reduction, as they definitely cheered me up and gave me a burst of energy too.
There is a logic in thinking that there's a strong link with how you feel. The corticosteroids that are used in the injections have a similar chemical structure to hormones, vitamin D and other things that affect mood. And anyway, it doesn't matter what the books say because if that's how you feel then it's true for you.
But have you thought about whether being diagnosed has made you somewhat depressed? Steroids can be mood altering so maybe that's what you are missing now? No matter how strong we are, I think we all go through a period where this gets to us and we need a bit of extra help, so perhaps you do need to discuss this with your GP?
Oh yes, and how! The initial injections and then the higher dose of tablets were fantastic, I was euphoric and so energised that I got masses done. I felt as if I could do anything -except sleep. But tapering was hell. The first time I did that, I sank into despair. I had to then go up again and come down much more slowly. Having had another 'steroid holiday', I'm tapering again now and even at 1mg Per month, not enjoying it. I'm down to 8mg. As usual, nomoreheels give some very useful information. Good luck.
Hello, I don't know if what I say is any help at all but I do believe any drugs that act as 'painkillers' can be very addicting. I am not sure what makes one person more prone to addiction than another but I have recently been put on oral steroids 'prednisone' a dose of 15mg per day, I understand this is not a high dose, albeit I only weigh 120lbs, so for me its enough. I'm pretty sure I am already addicted physically to this drug. I am pretty terrified when I will have to go off it..here's why.
I take my Prednisone at 7:00am every morning, and this is normal when I'm working on Day shifts, however when I am on Afternoon or Night shifts, my sleeping changes and I'm not always up at 7:00am to take my medications. Once I took it at 10:00am, three hours late, because I was sleeping. I woke up and felt like I was hit by a Mack truck! within a short time of taking my meds. I felt better. When I say 'short' tome, I mean almost instantly....within about 15 mins.
The next time, my medication was only two hours late, 9:00am instead of 7:00am, again this whole bodywide ache, like I was in a car accident. Again upon taking the presdnisone, I very quickly am fine again.
I have come to the conclusion that if i don't take my meds. on time, my body knows its missing, and sends out theses messages to me via pain, that it needs its prednisone. Now I'm terrified as to what will happen when I go off this drug. I am only on it until my government funding for Humira is approved, and have been taken of all DMARDS, so prednisone is the only medication I am on right now, other than NSAIDS as needed, but I find I dont need them when Im on prednisone, I actually feel wonderful on Prednisone, better than I have felt in a very long time, I still feel pain, but the 'edge' has been taken off, and I once again can move with ease......
I did do some research on this drug, your adrenal gland normally produces 5mg of steroid-like hormones per day. When you take the oral drug at 5mg or more a day, your adrenal gland stops producing, and the actual adrenal gland shrinks in size. The longer you are on steriods, the more the gland 'atrophies' and the longer and slower you need to taper, when going off the drug, so that the adrenal gland has time to 'grow back' to normal size. This is often not told to patients. I can tell you it was never told to me. Explaining it this way help the patient understand what is actually going on, and helps you to understand how important slow withdraw from the drug is.
I have had a steroid injection before but no tapering was needed, I think an injection is 'localized' and doesn't spread throughout your body like the oral steroids do. EX. if you get a steroid shot in your shoulder, it provides pain relief for your shoulder. Where as oral tablets produce pain relief through your entire body, so I am not sure the actual injection affect your adrenal gland the same way a localized injection does. An injection just wears off on its own, and the rate of this is different for everyone. I can understand someone getting anxious if their injection starts to wear off or doesn't last long. The injections do not work for everyone. For me an injection works within a few days and lasts months and months. for others it takes up to a week to start working and may only last a short time.
Its just my opinion but the skill of the person injecting may have something to do with it.
My GP gave me a steroid injection a long time ago, that did absolutely nothing...and I mean nothing.
Then my Rheumy gave me one (a long time ago) and I was blissful from relief for six months from one injection!
You mentioned 'mental' addiction to steroids. I m sure this can play a role, when you find a drug that relives pain, then try to accept they will withdrawal this drug, I can understand some anxiety delema of loosing something that works for you.
I personally do not feel mentally addicted, but I do know my body is now physically addicted, because it knows and craves the very next dose. I did not want to go on this drug, it scares me more then MTX did.
However, I also understand that my Rheumy feels I medically need this drug, so I take it.....I think for me, getting off this drug is going to be a challenge.
Wow!!! You've done your homework, & as I understand it have interpreted it all correctly. I've needed short courses of oral steroids off & on most of my RD journey but each time if a new Consultant prescribed them he or she fully instructed or rather informed me why the dose given & the importance of tapering safely & why, even going to the trouble to write down a sort of timetable. I've never had an issue coming off them until the last time but do take into consideration that the Registrar also asked me to only take my NSAID Cox-2 when absolutely necessary so little wonder I had a problem. Needless to say my GP reinstated my steroids until my appointment with my Rheumy who asked me to continue on low dose (3mg) & reinstated the etoricoxib & I remain on low dose until my next appointment in February when we'll discuss my protocol further. So as long as you're directed how to taper them correctly, preferably written instructions because it can be a bit of a pain remembering toward the end of tapering, you shouldn't go too far wrong Hobbits.
It may be worth questioning given your circumstances with work & shifts if oral pred is the correct way forward for you. It should be taken at a regular time, I've always been instructed with food in the morning (though guess that could differ depending on the dose, i.e. a larger dose split morning & night) otherwise being a hormone it can cause adrenal gland suppression, not good & that's what you've been experiencing I would imagine. x
I've been on oral and occasional injections of steroids for eight years after the RD affected my bone marrow.
Although the rheumy specialist is content for me to stay on 5mg prednisolone indefinitely, I'm not, and as he said "I expect you will do what you want anyway!"
I tried it twice now and had to go back up to higher doses because of problems with the RD. But now I'm trying again as the RD seems more or less under control at present with only what I now regard as minor swelling, stiffness and pain. I'm on azathioprine which seems to be better for me.
Until about 5mg, I can reduce without too much problem . But after 5mg, I find for about the first week after a dose reduction I feel dreadful, despite only reducing by 0.5mg. Depressed, fatigued and painful. This gradually wears off and by the fourth week on the lower dose I am ready to tackle it again. I have been helped by a friend who has done the same procedure and is successfully off the steroids now.
The advice from Hobbits is very relevant. If you look up "side effects from reducing steroids" you will find all the side effects to expect. But I think it is worth it so I persist, while bearing in mind that my adrenal glands might not cope with coming off all together!
I hope the advice you have helps with coping with what is a much more difficult task than is realised by the medical team.
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