prednisone anxiety

[Perf]

I just went from 4 mg. After one month you 3 mg. And am having lots of anxiety, shaking, is this from prednisone withdrawal? Would it be ok to take an anti anxiety med to get through this? Is this common? Thx!

[PMRpro Ambassador]

Hi and welcome!

Changing dose 1mg at a time at these low doses is a lot and your body takes a while to catch up. Yes, it is due to withdrawal of the pred but it is because your adrenal glands now need to start making cortisol again to make up for the pred that is being taken away. That doesn't happen overnight so the smallest possible dose changes and longer between drops helps.

What were you thinking of taking? Some things will probably be OK but you need to check it is alright with pred or any other medications you are on. The pharmacist should be able to help or a good PCP might prescribe something suitable.

[DorsetLady PMRGCAuk volunteer]

Would say it’s more likely to be adrenals struggling - it’s a common issue when they are. A smaller reduction- 0.5mg and a slowly taper will help them and your PMR. If you slow down - maybe returning to 4mg and staying there for a month or so, you may not need to add in any other medication

[Perf in reply to DorsetLady]

Thanks!

[marionofnorwich]

I have the same problem though i am on 4mg. I did try a drop to 3.5 for a few weeks end if last year but went back to 4mg soon after Christmas. Two weeks ago hit a stressful thing to deal with and my anxiety (and blood pressure) is off the scale. I am not naturally an anxious person but am currently feeling threat all around me and an inability to cope. Pretty sure it is the cortisol/adrenal glands not coping but not sure what to do about it. Hope that yours dorts itself out

[PMRpro Ambassador in reply to marionofnorwich]

You either have to increase the pred - which will just prolong the agony - or sit it out until the adrenal function catches up. But you could take the odd double dose when something is very stressful and you feel particularly awful. Do that too often though and it will set the adrenal recovery back.

[marionofnorwich in reply to PMRpro]

Yes, I am trying to sit it out at the moment at 4mg which is what Max said I would have to stay on indefinitely as he doesn't think my adrenal function will recover but I am holding out hope that it will as have never been under 3.5mg for more than a few days, so sticking at 4mg. I can tell my brain that everything will be OK it just doesn't feel it physically!

[PMRpro Ambassador in reply to marionofnorwich]

4mg is actually quite a low dose for adrenal function replacement - some need up to 7mg.

[marionofnorwich in reply to PMRpro]

But if I go up to 7mg, my adrenals definitely won't return will they? I don't feel unusually fatigued or anything commonly associated with low adrenal activity, just not coping well with/adjusting to a sudden stress

[PMRpro Ambassador in reply to marionofnorwich]

I struggle with that at 7mg to be honest, worse at 6mg though. So yes - in that case, no point going back really. Just hope it improves with time - though, I hate to have to say it, it is also a feature of aging as well!

[Perf in reply to marionofnorwich]

Hi thx for responding! I went down to three and a week later had to put my dog down. It was a double whammy for me. I ended up taking so Ativan as I didn’t want to I. Tease the prednisone.

[Ford29]

I went from 5mg to 4.5mg for one month, than 4mg for a month and now at 3.5 till the end of Feb. I have had good luck under 5 going down by .5mg. I did have a little flareup at 3.5 to start so I did every other day for a week 3.5, 4, 3.5, 4, 3.5 and then stayed at 3.5. I think my flareup may have be caused by a stress test I had to take?? This thing seems to be a roller coaster at times you just need to know your own body.

[knoone]

I understand your struggles. Like others, I have tapered .5 MG when below 10mg. That said, I give myself some grace. When I reduced from 5 to 4.5, the first day I started I could not get through a full 24hrs at 4.5. I made it 16 hours, but felt so bad I took an additional .5mg. After five days at 5mg, I did 4.5 again and it was manageable for 24 hours. However, the next week when I was scheduled to do two days at 4.5, I could only manage it for 34 hours, but the next week, I could do 48 hours. My point is, this is not an exact science, and as long as your making progress, even in hours, you are getting to your goal.

Good luck