I have a rare auto-immune disease that requires high (160mg 2x day) dose prednisone to stop a severe blistering of mucosal tissue ., 2-3 degree burns of mouth, throat, sinus, eyes and even my heart. The possibility of this disease killing me without prednisone is real and my doctor explained that prior to prednisone a great majority of people with Erythema Multiforme – Major died.
So what’s the problem? Over many years and a dozen high dose treatments with prednisone I have been 302 committed and upon release my doctors where cautioned about this therapy.
During my most recent treatment, I went into a manic state or worse. I was PFA’d and removed from my home by police after scaring my wife and kids. I had to finish treatments at the hospital and I requested a psychological evaluation because I hadn’t slept in 5 days, almost lost my job, and was was manic or worse. After a discussion with a psychiatrist he added several different mood stabilizers and anti psychotic meds. I have come off the prednisone and the pshyc meds are taking effect. I cant wait until prednisone is out of my system.
My doctor now realizes after this last event a new protocol is being thought out with future treatments.
This I can tell you without a doubt in my mind that Prednisone is a miracle and a curse all rolled up into one medicine. If you are experiencing mental issues with prednisone tell your doctor immediately, insist on getting psychiatric support and PRAY.
Steroid-induced osteoporosis (SIOP) is osteoporosis arising due to use of glucocorticoids (steroid hormones) - analogous to Cushing's syndrome and involving mainly the axial skeleton. The synthetic glucocorticoid prescription drug prednisone is a main candidate after prolonged intake. Bisphosphonates are beneficial in reducing the risk of vertebral fractures.  Some professional guidelines recommend prophylactic calcium and vitamin D supplementation in patients who take the equivalent of more than 30 mg hydrocortisone ( mg of prednisolone), especially when this is in excess of three months.   The use of thiazide diuretics, and gonadal hormone replacement has also been recommended, with the use of calcitonin, bisphosphonates, sodium fluoride or anabolic steroids also suggested in refractory cases.  Alternate day use may not prevent this complication.