Symptoms of withdrawal from steroids
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Symptoms of Withdrawal from Steroids
Introduction to Steroid Withdrawal Symptoms
Steroid withdrawal can occur when individuals abruptly stop or significantly reduce their intake of corticosteroids or anabolic steroids after prolonged use. The symptoms can be diverse and severe, affecting both physical and psychological health. This article synthesizes findings from multiple research studies to provide a comprehensive overview of the symptoms associated with steroid withdrawal.
Physical Symptoms of Corticosteroid Withdrawal
Arthralgia and Myalgia
One of the most common physical symptoms of corticosteroid withdrawal is the recurrence of joint pain (arthralgia) and muscle pain (myalgia). These symptoms are particularly prevalent in patients with underlying conditions such as rheumatoid arthritis, where the cessation of steroids can exacerbate prior symptoms 13.
Gastrointestinal and Dermatological Symptoms
Patients often experience gastrointestinal issues such as anorexia and nausea, along with dermatological symptoms like desquamation (peeling of the skin) 13. These symptoms are indicative of the body's struggle to readjust to the absence of steroids.
Adrenal Insufficiency
In severe cases, withdrawal can lead to acute adrenal insufficiency, characterized by hypotension, lethargy, and fever. This condition arises due to the suppression of the hypothalamic-pituitary-adrenal (HPA) axis during prolonged steroid use 138.
Psychological Symptoms of Steroid Withdrawal
Depression and Mood Disorders
Withdrawal from anabolic steroids, commonly used for bodybuilding, can lead to severe depressive episodes. Symptoms include lowered mood, loss of energy, anhedonia (inability to feel pleasure), suicidal thoughts, disturbed sleep, poor appetite, and impaired concentration 5910. These psychological symptoms highlight the significant impact of steroid withdrawal on mental health.
Dependence and Addiction
Both physical and psychological dependence on steroids can develop, leading to withdrawal symptoms when the drug is discontinued. This dependence is often accompanied by mood disorders, insomnia, decreased libido, fatigue, and a strong desire to resume steroid use 8910.
Specific Symptoms of Topical Corticosteroid Withdrawal
Erythema and Burning Sensation
Topical corticosteroid withdrawal, often referred to as "steroid addiction," primarily affects the skin. Symptoms include erythema (redness), burning, and stinging sensations, particularly on the face and genital areas. These symptoms are more common in women and are often a result of long-term inappropriate use of potent topical corticosteroids 67.
Secondary Skin Lesions
Patients may also develop secondary skin lesions such as scales, which further complicate the withdrawal process. The condition can be divided into two subtypes: papulopustular and erythematoedematous, with the latter presenting more severe symptoms like burning and edema 67.
Conclusion
Steroid withdrawal can manifest through a wide range of physical and psychological symptoms, significantly impacting the quality of life. Understanding these symptoms is crucial for effective management and treatment. Healthcare providers should be vigilant in monitoring patients undergoing steroid withdrawal to mitigate these adverse effects and provide appropriate support.
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Most relevant research papers on this topic
Letter: Acute arthralgia following high-dose intravenous methylprednisolone therapy.
High-dose intravenous methylprednisolone therapy, which can cause severe withdrawal symptoms in kidney-transplant recipients.
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Steroid withdrawal syndrome can cause various symptoms, including high fever, and is often overlooked, with potential implications for chronic pain management.
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Steroid withdrawal syndrome in tuberculosis patients may result in Cushing's syndrome-like symptoms, with potential implications for steroid therapy in tuberculosis treatment.
Non-RCTHighly CitedA Case Report of Steroid Withdrawal Syndrome
We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing’s syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.
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Very Rigorous JournalDepression in anabolic steroid withdrawal
Prolonged exposure to anabolic steroids followed by withdrawal can cause severe depression in young physically active individuals.
Case ReportA systematic review of topical corticosteroid withdrawal ("steroid addiction") in patients with atopic dermatitis and other dermatoses.
Topical corticosteroid withdrawal is a distinct clinical adverse effect of misuse, with burning, stinging, and erythema being the most common symptoms.
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Rigorous JournalHighly CitedTopical corticosteroid withdrawal (‘steroid addiction’): an update of a systematic review
Topical corticosteroid withdrawal is a potential diagnosis for patients with prolonged usage, erythema, and burning or itch symptoms.
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Evidence for physical and psychological dependence on anabolic androgenic steroids in eight weight lifters.
Steroid dependence in weight lifters is common, with withdrawal symptoms and psychiatric symptoms being prominent, emphasizing the need for diagnosis in clinical practice.
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