Side effects of prednisone
DEAR DR. ROACH: An 80-yearold was mistakenly prescribed prednisone, 40 mg, for six months and is now being weaned off over four weeks.
While on the prednisone, she had some symptoms that I think are side effects, including sleeping all day, no energy, losing weight (30 pounds over six months without trying), hair falling out, thinning skin, hallucinating and bumping into the wall, causing bruises.
She is scared of the dark, does not want to be left alone and gets confused. Her blood sugar has gone up dramatically (A1c from 6.7 to 11).
Will these symptoms get better once she is weaned off the prednisone?
ANSWER: Most of the symptoms you describe are plausible side effects of a large dose of prednisone in an older person. Prednisone is a powerful antiinflammatory and immune system suppressant that is used for many conditions. However, it has the potential for many side effects.
Although more often people can get jittery and jumpy from prednisone, fatigue is certainly possible. Hair and skin changes and easy bruising are routine. What puzzles me, though, is the weight loss, since weight gain is much more common.
I assume she was known to be diabetic before, since her A1c level was consistent with controlled diabetes.
The worsening of the blood sugar control suggests worsening insulin resistance, which usually is due to weight gain, not loss. The confusion and hallucination are less common, but more concerning side effects.
It is very disturbing that these effects have been going on for six months, apparently without being addressed.
Worse still, the medication was given as a mistake? I don’t know the whole story, but it sounds very disturbing.
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