What is DSNS?

[PMRgo]

Good afternoon. This is my 1st post, so forgive my ignorance. I've read a number of posts talking about reducing prednisolone by the DSNS method. Can some kind soul explain what that means?

I had to go back to 10mg after gradually reducing to 6mg from 20mg over a year, but j feeling worse and worse until my rheumologist had the proof of inflammation through blood tests. 10mg was great and magical for 2 months. Now on 9mg, but I am alternating 10mg and 9mg as I did start getting a bit stiff after 3 days. I hope to get to 9mg only and then reduce again to 8mg after a month.

What's the difference between this and DSNS?

Very grateful for any answers.

[PMRpro Ambassador]

healthunlocked.com/pmrgcauk...

It a way of slowing down the steps of reducing so that your body is challenged with a new lower dose one day at a time at first so it can get used to it bit by bit. It reduces the discomfort of reduction and makes it easier to identify the dose you are seeking: the lowest dose that manages the symptoms as well as the starting dose did.

It is much more gradual than what you are doing - which is fine of it works but it doesn;t for everyone. If you start to notice symptoms again it is always a sign to stop reducing for a while and reassess. You might not manage it this month or even next month but you usually manage eventually and forcing a reduction step just results in having to return to a higher dose - it just isn't worth it.

[PMRgo in reply to PMRpro]

Thank you for your quick reply. I have decided to go more slowly, as I don't want to have to go back to higher doses again.

[PMRpro Ambassador in reply to PMRgo]

Good choice - it really isn't a race! And tortioses usually win ...

[DorsetLady PMRGCAuk volunteer]

Stands for Dead Slow Nearly Stop -

Here it is explained -

healthunlocked.com/lupusuk/...

You can see that it takes longer to get from existing dose to new one - and was designed for people who had problems reducing.

If you are particularly susceptible to dose changes you can reduce by 0.5mg a time instead of 1mg. So long as you have plain white uncoated tablets they can be cut - or mix and match between the 3 strengths available - 5mg, 2.5mg and 1mg.

Any further questions, please ask.

[PMRgo in reply to DorsetLady]

Thank you so much for that, and such a speedy reply! In fact,it was what I've been doing, although not as slowly. I shall reduce the doses more slowly, as I think my rheumatologist is a bit too optimistic and too worried about bone density problems.

[piglette in reply to PMRgo]

Not unusual a lot of doctors are worried about steroids and bone density or steroids full stop even. My bone density is good and even then I have stand up rows with them about me taking bisphosphonates.

[PMRpro Ambassador in reply to PMRgo]

And my bone density barely changed in over 7 years on pred, most of it at above 10mg ...

[ignatz in reply to DorsetLady]

Many thanks for posting that link. Looks like a worthwhile approach to reduction.

[Louisepenygraig]

I see other people have answered with the details now so I don't need to. One thing I like about the DSNS taper is you can be fairly flexible thus doing it more slowly or quickly depending on circumstances. I recently needed to back up to 15 having found 9.5 was too far. Because I was fairly confident that 11 was ok, and possibly10, I dropped quite quickly, 1 mg at a time then used the DSNS method to drop .5mg from 11 to 10.5 then to 10, but instead of starting with one day new dose then 6 days old I just did 4 at the old dose. It worked for me. I think i may have had a pause in the middle on the second taper when I wasn't sure how it was going. I'm staying on 10 now until I get back from a planned holiday in September then I may try going down to 9.5 again very slowly

[SheffieldJane]

It stands for dead slow nearly stop x

[HeronNS]

Put yourself on a bone healthy regimen and never worry about your bones again. This is what I did (still do) :

healthunlocked.com/pmrgcauk...

[SnazzyD]

Think of it as reducing dose less like going down stairs but a gentle slope.