What are the side effects of coming off steroids

Prednisone is not addictive, but people can experience withdrawal symptoms when they stop taking the drug. Learn how the steroid causes uncomfortable withdrawal symptoms.

Prednisone is a synthetic steroid hormone prescribed for a variety of conditions including asthma, autoimmune disorders, and organ transplants. Prednisone is not an addictive substance but taking it for longer than a few days can cause withdrawal symptoms.

If it sounds strange that a non-addictive drug can cause withdrawal, consider how hormones work. Near the kidneys are two small glands called adrenal glands. The adrenal glands release hormones that tell different parts of the body what they should do. Hormones are like switches in the body. When enough of a hormone enters the bloodstream, the body interprets the message and acts accordingly.

Hormones are signal molecules, but what is a steroid and how are they related? Not all steroids are hormones, and not all hormones are steroids, but prednisone is both. The drug is molecularly shaped like a steroid and sends signals to distant parts of the body like a hormone.

Prednisone Withdrawal

Prednisone withdrawal occurs when people take the drug for too long. Understanding how the drug interacts with natural hormones helps clarify how the drug can cause withdrawal symptoms. Prednisone mimics the natural steroid hormone cortisol. When stressed, the body releases cortisol. The released cortisol has the following functions:

• Breaks down fats, proteins, and carbohydrates: Cortisol regulates hunger and helps increase the metabolism of the food that we eat. During stressful situations, the body anticipates it will need more fuel to react to danger. So, cortisol causes hunger and can lead to weight gain over long periods.
• Increases blood sugar: The body stores sugar as the molecule glucose and then links glucose molecules together as glycogen. Cortisol signals the body to break down glycogen stores into smaller glucose molecules. Glucose enters the bloodstream and causes a spike in blood sugar.
• Suppresses the immune system: The immune system takes a lot of energy for the body to maintain. During a stress response, the body reduces its ability to fight off an infection. Since cortisol is telling the body it is under a direct threat, cortisol shifts the energy usage from long-term defense (the immune system) to short-term defense (fight or flight).

When someone starts taking prescription prednisone, their body recognizes the extra steroid hormone and starts making less cortisol. The adrenaline glands are efficient at adjusting to extra steroid hormones because too much would be harmful. Once the adrenal glands adjust, people taking prednisone become dependent on prednisone to provide the natural baseline level of cortisol. This process takes several days.

Once the body becomes dependent on prednisone, if a person suddenly stops taking prednisone, their adrenal glands will continue making less-than-normal levels of cortisol. The body takes several days to adjust to the lack of prednisone. Until the body can produce more cortisol, this person will experience prednisone withdrawal.

For prednisone withdrawal, remedies at home are generally not helpful. In this case, withdrawal happens because the body is not producing enough cortisol.

Prednisone Withdrawal Symptoms

If prednisone use is halted after a period where the body developed a dependency, withdrawal symptoms may develop. While experiencing prednisone withdrawal, a person may experience:

• Body aches and pains
• Fatigue or tiredness
• Joint pains
• Lightheadedness
• Low appetite
• Nausea and vomiting
• Unintentional weight loss
• Weakness

Prednisone withdrawal symptoms will generally resolve on their own or with the help of a taper.

Topical steroids can produce symptoms similar to prednisone withdrawal. A rash is a common difference between oral prednisone and topical steroids.

How Long Prednisone Withdrawal Lasts

Prednisone and other steroids must be tapered slowly to allow the adrenal glands to readjust to how much cortisol they produce. A typical tapering regimen can last anywhere from days to weeks depending on the dose of prednisone a person used and how long they used it. Most prednisone regimens longer than five days will need a taper.

Prednisone Withdrawal Medications

The treatment for steroid withdrawal syndrome (SWS) is to slow down the steroid taper or increase the dose being used. A doctor should either extend the length of the “step” their patient was on or increase the dose of that step.

For example, if a person took 20 mg for five days and decreased to 10 mg and experienced withdrawal, the doctor could:

• Return the dose to 20 mg for a few days
• Increase the dose to 15 mg before moving down to 10 mg

Prednisone Withdrawal Deaths

Prednisone withdrawal is not deadly, just uncomfortable. Such uncomfortable symptoms include fatigue, vomiting, and lightheadedness. Those types of symptoms can cause dangerous situations (e.g., driving a car while fatigued), but prednisone withdrawal itself is not deadly. For safety, it’s best to plan a taper schedule with a doctor.

Prednisone Withdrawal Cold Turkey

Stopping prednisone “cold turkey” is not recommended. Ideally, a doctor would taper the patient by prescribing a dose that slowly reduces the amount of prednisone consumed to give the adrenal glands time to adjust production of cortisol. This process helps to avoid withdrawal symptoms. If a person took prednisone for more than five days, they should consider speaking with their doctor about tapering.

Prednisone Withdrawal Tips

Keep the following tips in mind when attempting to withdraw from prednisone:

• Speak to a doctor about symptoms to gauge withdrawal risks
• Get a healthy amount of sleep
• Eat healthy meals
• Exercise normally
• Understand that the withdrawal symptoms will pass

Prednisone Detox

Prednisone leaves the body in about a day, however, the effects of steroids last several days. A person should never need a prednisone detox as long as they communicate their needs with their doctor.

Forgetting to take prednisone for a day or two will not trigger withdrawal symptoms, but if a person waits any longer they might cause withdrawal symptoms to develop.

Prednisone Detox at Home

In the hospital, prednisone withdrawal is closely monitored and patients should not experience any withdrawal symptoms. However, if a person is tapering at home, they should make sure to follow the directions on their prescription carefully. The taper is designed to prevent any withdrawal symptoms, so patients should follow it closely. If a person follows the taper and still experiences withdrawal, they should call their doctor for an adjustment to be made.

Helping Someone Withdrawing or Detoxing from Prednisone

To help someone as they stop taking prednisone, make sure they follow the directions on their taper prescription. Using a pill-box with labeled days might be helpful. Other options include writing the daily dose on a calendar or using a calendar app on a smartphone to make sure they do not forget to take their dose.

Finding a Prednisone Withdrawal and Detox Center

Prednisone withdrawal is not treated in an addiction or rehab center since it is not an addictive medication. Prednisone can cause physical dependence and withdrawal symptoms if used longer than five days. If someone experiences symptoms of prednisone withdrawal, call a doctor or go to an urgent care clinic.

If a person forgets to pick up their medication or takes tapering medication incorrectly, they might experience uncomfortable withdrawal symptoms. A prescriber can help correct that with an appropriate additional prednisone prescription.

Most medications that cause withdrawal are addictive, but prednisone is not. If you or a loved one have an issue with an addictive medication, contact The Recovery Village to speak with a representative about how addiction treatment can help you achieve the healthier future you deserve.

Editor – Thomas Christiansen

With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more

Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP

Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

Bhattacharyya, A; Kaushal, K; Tymms, DJ; Davis, JR. “Steroid Withdrawal Syndrome after Suc[…]rome: A Reminder.” European Journal of Endocrinology, 2005. Accessed June 19, 2019.

Dhossche, Julie; Simpson, Eric; Hajar, Tamar. “Topical Corticosteroid Withdrawal in […]ediatric Patient.” 2017. Accessed June 19, 2019.

Chang-Miller, April. “Do You Know What Problems Can Occur w[…]op of Prednisone?” Mayo Clinic, 2017. Accessed June 19, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

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