PMR: Are there treatment alternatives to Prednisone?
Hi, all. I'm wondering if anyone is finding any alternatives to Prednisone in treatment of PMR?
I've been on the PMR/Prednisone train for about 6 months now (was in pain and stiffness for a year or two before but just thought I was "getting old"), being treated through Rheumatology at Shands Hospital (Great people, like Mayo, I'm sure.) in Gainesville, FL. I started at the high dose of 60 mg, it was amazing--within days I felt like I was invincible, having delusions of grandeur due to "Prednisone Psychosis" (It's a thing. And I ride it for all it's worth. 🙂 )
--and launched into crazy lucid dreams and auditory hallucinations--honest to God, one night I heard Wolf Blitzer from CNN standing at the foot of my bed and in a clearly audible voice say: "Right." -and I was up for the night and most nights after. In fairness to my brain, I watch The Situation Room sometimes, so I should've seen that coming.
I was only sleeping, like 1-2 hours a night, but had incredible energy. My nocturnal meanderings included a voracious appetite--for which I tried to stave off weight gain by eating large quantities of vegetables. My wife refers to me as "The Were-rabbit", with appropriate emojis. And with my morning evacuations I could fertilize half of England. I've retained fluids to the point that I look kind of like a squirrel with a mouthful of acorns? Only without the benefit of said nutritional content. I look like--if Alfred Hitchcock and Winston Churchill had a love child? I would be that child.
These days, I've tapered down to 15 mg/day, and the pain and stiffness are returning. Now I look like Winston Churchill/Alfred Hitchcock (Where did my chin go? I distinctly remember having a neck.), only I'm dragging out my cane again (Okay, that's a little Churchillian, at least) to get up and move around.
If I sleep 5 hours at a stretch, I call that:
"Boy, I'm sleeping the whole day away!"
Fortunately for me, I'm teaching remotely via Zoom, and my students are all so kind as to not ask what happened to my chin. Some days, I can't even remember if I was wearing pants. They love me for the madman that I am.
As I consider increasing dosage and heading back into Prednisone Psychosis land, I wondered if there's an alternative to allow me to hop off the train?
Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.
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@monigue
I was diagnosed with AFib years ago and started feeling PVCs and PACs several years ago. I'm on eliquis to help mitigate the stroke risk, and sotalol and verapamil for my PVCs and PACs. I was given a prescription to take as needed for my BP issues. I seldom used it. I was relatively symptom free until I started prednisone two months ago. A slight increase in sotalol eliminated the PVCs and PACs and I take a small dose of BP meds every day now (1/4 of the prescribed pill). I need the prednisone or an alternative so I can function daily. Just like the PMR symptoms themselves, the prednisone side effects vary from person to person.
@monigue
For what it's worth, I am 83, have had arrhythmia, am on Eliquis, and have been on prednisone for PMR for the past 12 months. I have tapered from 40 to now 7 mg a day with the recent help of Kevzara. No heart problems. Just recurring pains from osteoarthritis that were concealed by the prednisone. I will get the annual cardiology check in the next few weeks and will let you know if I have problems caused by prednisone but so far so good.
You might investigate Kevzara as an alternative to prednisone. Most of us seem to use it to help taper off prednisone but it may be an alternative to prednisone which would be wonderful. Expensive though if not covered by insurance.
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