Steroid Drug Withdrawal: Symptoms, Treatment, Side Effects and More

Synthetic cortisone medications (corticosteroids) simulate cortisol, a naturally occurring, anti-inflammatory hormone produced by the adrenal glands. Such drugs (for example, prednisone) benefit many also have potential side effects.

The two major problems related to continuous steroid treatment include:

The production of corticosteroids is controlled by a “feedback mechanism,” involving the adrenal glands, the pituitary gland, and the brain, known as the “hypothalamic-pituitary-adrenal axis” (HPAA). Using large doses for a few days or smaller doses for more than 2 weeks leads to a prolonged decrease in HPAA function.

Steroid use cannot be stopped abruptly; tapering the drug gives the adrenal glands time to return to their normal patterns of secretion. Withdrawal symptoms and signs (weakness, fatigue, decreased appetite, weight loss, nausea, vomiting, diarrhea, abdominal pain) can mimic many other medical problems. Some may be life-threatening.

Tapering may not completely prevent steroid withdrawal symptoms. Steroid withdrawal may involve many factors, including a true physiological dependence on corticosteroids.