Worries and Side effects of Prednisone

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If you suspect that your child's Autism is due to a dysfunctional immune

system ...

and/or viral mediated ....

doris

Worries and Side Effects About Prednisone?

What should we worry about? Who should avoid taking it? What are the

side effects?

General Guidelines

The following are general guidelines; you must discuss these issues

thoroughly with your pediatrician and neurologist

* Prednisone severely represses the immune system, and the high

doses required for treatment cause the body to shut down its

natural production of cortisone. Therefore, you cannot just stop

giving it, The child must be weaned off.

* Children must be under continuous medical care during the

treatment period, 4-6 months plus weaning-off period of about 2

months.

* Children who cannot go through full regimen (e.g., if you will be

moving overseas and are unsure of medical accommodations) should

not start until they can be under continuous medical care.

* Children with chicken pox or other short-lived viral diseases

should not be put on prednisone until their illness has passed.

* Some people have considered a " stealth virus " as a cause of

autism. However, no neurologists have noted the types of reactions

to prednisone that would be expected from an undetected viral

infection being present (notably, a dramatic worsening of the

symptoms as the immune system is suppressed), so it is highly

unlikely that the " stealth virus " theory plays a role in autism

and Autistic Spectrum Disorders.

* Children who have recently had surgery should wait until the body

has fully healed.

* Children with diabetes or an underlying immunodeficiency syndrome

should not be put on prednisone.

First, note that the length of treatment (4-6 months) is long, but not

overly so -- children with severe asthma, leukemia, epilepsy and other

diseases are sometimes on prednisone for a year or more. Therefore, the

risks from long-term use, while not inconsiderable, are controllable. It

is vital that the child be monitored continuously to avoid problems -

this includes regular urine glucose, blood pressure and blood potassium

level testing, and continuous surveillance by the parent for any signs

of problems (e.g., a cold that won't go away).

Short-term Effects

These short term effects that will appear during treatment but disappear

afterwards include:

* Increased appetite and weight gain (but this should not interfere

with any dietary interventions)

Cushingnoid appearance (bloating and swelling due to water

retention, as well as eating more): this looks bad but is not harmful.

* High blood pressure, increased blood potassium, sugar in urine:

requires regular monitoring, so that you can adjust the dosage to

compensate. This is not a high risk factor if the monitoring is

done regularly.

* Bone thinning: Must assure activity and calcium, vitamin D

supplements. Calcium, magnesium, potassium, phosphorus levels can

be determined by bloodwork drawn on a routine basis (biweekly or

monthly depending on protocol).

* Irritability, fitful sleep: not a health risk (and actually, some

children sleep better)

* Infections: If exposed to colds or other diseases, the child must

be monitored closely by his doctor since his immune system will be

suppressed. This side effect may be critical, and the one that

must be most closely monitored. For this reason, some parents may

wish to wait until cold/flu season is over before starting treatment.

Potential Long-term Effects

* Cataracts: Given the length of treatment and generally young age,

this is not seen as a risk. To be absolutely safe, the child must

see an opthamologist at yearly intervals, which you should

probably do anyway. For the most unlikely but worst possible

outcome, cataracts can be corrected surgically.

* Bone loss: Generally not a factor for younger children, but should

be monitored if there are any signs of osteoporosis or bone

thinning, especially in the femur (thigh bone). May be a problem

if child was on prednisone for long periods for other afflictions,

e.g., asthma.

* Growth stunting: This is not a health risk, and although it may be

a problem with treatment periods of greater than six months, it is

generally not a factor in current protocols. Some children

actually grow more during treatment. Some children may experience

" catch up growth " after steroids are discontinued.

Other

You cannot take child off prednisone immediately, since it suppresses

adrenal glands. Weaning takes about two months of gradually reduced

dosage. However, the adrenal glands are not permanently affected, and

they eventually recover their normal function, although this may take

many months.

Finally, prednisone taken orally is very bitter and tastes terrible

(even when flavored - cherry works best), and it is often a battle to

get it down the kid's throat. Pulse doses may be given orally by pill,

or anal suppository (this is no joy either).

Questions or comments about Prednisone and Autism? Email us at

prednisone@... <mailto:prednisone@...>.