Posted by Gordon (220.127.116.11) on May 26, 2001 at 00:29:33:
In Reply to: Prednisone??? posted by Rachel on May 25, 2001 at 20:15:31:
This is from a couple of my books:
USES: Reduces inflammation caused by many different medical problems. Treatment for some allergic diseases, blood disoorders, kidney diseases, asthma and emphysema. Replaces corticosteroid deficiencies.
WHAT THE DRUG DOES: Decreases inflammatory responses.
ADVERSE REACTIONS OR SIDE EFFECTS: (just some) Mood change, fatigue, restlessness, headaches.
OTHER COMMENTS: This drug is often taken on a decreasing-dosage schedule (four times a day for several days, then three times a day, etc.)
MY PRESCRIPTION: Take 80 mg daily for 3 days then decrease by 10 mg daily until gone.
According to the survey here, it is the first drug to use for prevention at 17%, but 46% of the people haven't tried it.
And this is a quote from this site:
For the episodic form of cluster headache, prednisone is highly effective in over 75 percent of
patients (Kudrow, 1978) (Table 6-3). The value of prednisone has been established in a
double-blind study (Jammes, 1975), and it is clearly a first-line drug, if not the drug of choice in
this situation. The dosage has varied from 10 to 80 mg daily in various studies (Couch and
Ziegler, 1978). I use 80 mg per day for 7 days and then rapidly taper the dosage over 6 days.
Pain paroxysms usually cease within hours for the first dose. If there is no response after 48
hours, prednisone should be stopped and an alternative therapy instituted. If, while the dosage is
being tapered, headaches return, prednisone may need to be continued for the duration of the
cycle, preferably on an every other day basis, at dosages less than 140 mg weekly. Many
patients have to take prednisone for 5 or 6 days, but then stop it and find that the bout is over.
This has happened often enough to convince me that prednisone can actually terminate the bout for
about 20 percent of patients. Watson and Evans (1987) made similar observations in 2 of 11
steroid-treated patients with the chronic form of the disorder. It is, therefore, worth treating the
chronic patients with a 2-week course of corticosteroid, with the aim of interrupting the cycle,
although in most headaches return when the dosage is tapered.
I have seen several patients who were unresponsive to full dosages of prednisone, but who
responded spectacularly to triamcinolone at dosages of 32 mg per day.
The remarkable efficacy of corticosteroids in this syndrome is not easily explained. McEwen et
al, (1986) have reviewed the many potent actions of the corticosteroids on the CNS, but these are
just beginning to be defined. De Kloet et al (1986) studied the relationship of corticosteroids to
the serotonergic projection from the dorsal raphe nucleus to the hippocampus in rat brain; they
found that corticosteroids exerted tonic control on serotonergic neurotransmission in this system.
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