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Corticosteroid Withdrawal (Steroid Withdrawal Syndromes, SWS)

Description

Discontinuation of corticosteroid therapy may be followed by a number of symptoms that sometimes may resemble a withdrawal syndrome. The severity of the reaction depends on the dose and duration of corticosteroid therapy as well the endogenous ability to secrete glucocorticoids.


Conditions to consider when corticosteroids are reduced:

(1) flare-up or relapse of the disease being treated with the corticosteroids

(2) adrenal insufficiency (Addisonian crisis, with low serum cortisol concentrations)

(3) adrenal insufficiency-like (but with normal serum cortisol concentrations), which responds to corticosteroid therapy

(4) steroid pseudorheumatism (arthralgias and myalgias)

 

Symptoms that may develop associated with corticosteroid withdrawal:

(1) nausea and vomiting

(2) anorexia

(3) weight loss

(4) myalgias and arthralgias, generalized body aching

(5) fever

(6) headache

(7) somnolence

(8) fatigue and lethargy

(9) skin desquamation

(10) abdominal pain

(11) emotional lability and mood swings

 

It is important to monitor patients receiving corticosteroids for signs and symptoms of a withdrawal syndrome when reducing the dose.


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