I've been tapering from 15. From 10 downwards by 1 mg per month. All fine to 5mg but when I went to 4mg I found myself feeling depressed. I've had depression before an am aware of my symptoms. Kept it up for 3 days but too much of a coincidence so went back on 5 and that had me back to normal very quickly.
Has anybody else experienced this and if so, if you persevered, how long did the depression last?
I've got several trips booked this year and the longest gap when I could try to get back OK on a lower dosage is 6 weeks.
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Hercules307
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This has been a very common thing for me. Each time I made a drop l, even half a mg at a time, It usually lasted about a week to ten days, almost like my system was readjusting , then I was ok until the next drop. I am using a dead slow tapering method so it normally takes me about three months to go from one dose to the next. I would say, that I finally had to get some medication for anxiety but there was a lot of extra things going on that kind of tipped the balance. Hope this helps.
There have been several people recently complaining of low mood and even depression as they get to lower doses of pred as they taper. It is a recognised effect of poor adrenal function.
Not fun , me too. Each prednisone sparing drug trial (at least 4 since 2018) i would go through a tapering régime and all the associated issues including low mood and physical fatigue feeling. Meanwhile having 5 orthopedic surgeries and their associated phsio rehab. I have some first hand appreciation of what you are speaking to.. hang in there and as previously stated comments. Big picture you are getting a first hand understanding of your personal physiology.. " knowledge of the path, is no substitute for walking it"... take care and pursue you health
As PMRpro says probably adrenals -have a read of first link -and very slow taper (various in FAQs -see second link) and small steps (0.5mg a time) are the way forward -
Not sure whether my low mood days would really qualify as depression, but since I tapered below 5 mg (on 3 mg at present), I've had days when my get up and go has got up and gone down the drain. Some days are ok, I get out and walk for a while, do a bit of ironing, a bit of gentle gardening, but others are couch days when it's hard to motivate myself to even prepare meals. It's the time of the year when we start getting invited to lots of end of school year dinner parties (I used to work in education) and I have a very hard time dragging myself out in the evenings.
I think, as DL says, that it's due to poor adrenal function, and I live in the hope that adrenals will finally kick in and that remission will come some day in the not too distant future and then I'll be able to look back at this time of my life as a parenthesis.
Not sure I would class mine as depression but my mood is low and I'm not a nice person to know when I start to taper to the new dose. After my last taper to 4mg my rheumatologist suggested I stayed at 4mg for 3 months. I've just started a very slow taper to 3.5mg and so far I haven't experienced any low mood days🤞
Hi, not had experience of depression. You've done well with 1.0mg/month from 10mg, many here wouldn't have managed that, but would suggest that a slower tapering from your present 5mg will help with things going forward. I usually work on 0.5mg every five weeks, but even then I don't move to the next taper unless I'm happy with how things are going. At these levels there is no rush.
I share your symptoms and seem fine at 7mg but not at 6mg. Think PMr had gone but due to other illness been on pred 12years and know I am adrenally insufficient. I wonder when you call it a day, stick with the lowest dose of pred that keeps you mentally well and give up trying to reduce!
It sounds like you are very sensitive to a reduction in dose and I can relate to that. One option would be to make the reductions 0.25mg (5%) so for 4.75mg that would be 1mg + 2.5mg+ half a 2.5mg tablet and follow a slow DSNS taper protocol which you may have to extend beyond the 5-6weeks time-line. All of your planned trips could be classed as stressful from a biochemical point of view as even "excitement" requires adrenaline and cortisol. We talk a lot about the Adrenals needing to "wake up" but of course in reality it is the whole HPA axis which needs to function normally. I suspect the depressed mood you describe isn't depression in the true biochemical / neurophysiological sense but due to your hormones and neurotransmitter chemicals being in disarray. The changes in mood, lethargy, poor concentration and feelings of disinterest are real manifestations of tapering off steroids at the lower doses. It will sort itself out but you have to be patient and try and keep your personal ship on a very even keel throughout. Personally I've found this part of the PMR journey harder than dealing with the active illness and if I'm honest, I rarely know from one day to the next, how the following 24 hours will pan out, but overall things are improving.
Between 5mg and 4mg I experienced waking up with a feeling of dread. Through the day I had low mood and was agitated, wanting to kick off at anything that annoyed me. (Had to bite my tongue quite a bit.)
This stopped almost immediately when I went down to 3.5mg. I feel far less agitated and much happier. I assume it is probably adrenals combined with a bit of pred mystery.
So long as you don't have PMR symptoms it is best to push through the adrenal issue, though using a gentler regime from 5mg like reducing by 1/2 or a slow taper.
However, you say you have experienced depression in the past and you have got some big things coming up so it may be best to reduce when you have time to put your strategies for combatting depression into gear and don't have travelling stress to face.
It's great you're not getting PMR symptoms, but you will have to tackle the adrenal issue. But it will get better when the adrenals get over their hump and start working better - the level of pred at which this happens varies.
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