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Wolkowitz et al. (2001) presented a 10-year-old male patient, with no prior psychiatric history, who showed significant declines in academic performance that began during a 5-week course of glucocorticoid treatment for acute asthma flare. [1] The medications included prednisone, and methylprednisolone, plus albuterol, beclomethasone ...
To prevent steroid-induced osteoporosis, the steroid dose and duration should be as low and as short as possible. All patients on long term glucocorticoids (≥3 months) should be encouraged to do weightbearing exercise, avoid smoking and excess alcohol and take fall prevention measures.
Prednisolone is a synthetic pregnane corticosteroid closely related to its cognate prednisone, having identical structure save for two fewer hydrogens near C 11. It is also known as δ 1-cortisol, δ 1-hydrocortisone, 1,2-dehydrocortisol, or 1,2-dehydrohydrocortisone, as well as 11β,17α,21-trihydroxypregna-1,4-diene-3,20-dione. [50] [51]
Prednisone is a synthetic glucocorticoid used for its anti-inflammatory and immunosuppressive properties. [36] [37] Prednisone is a prodrug; it is metabolised in the liver by 11-β-HSD to prednisolone, the active drug. Prednisone has no substantial biological effects until converted via hepatic metabolism to prednisolone. [38]
Hypnotic medications are equally effective in the short-term treatment of insomnia, but their effects wear off over time due to tolerance. The effects of CBT-I have sustained and lasting effects on treating insomnia long after therapy has been discontinued. [130] [131] The addition of hypnotic medications with CBT-I adds no benefit in insomnia ...
Biofeedback has been shown to be an effective treatment for insomnia and is listed in the American Academy of Sleep Medicine treatment guidelines. This form of therapy includes visual or auditory feedback of e.g. EEG or EMG activity. This can help insomnia patients to control their physiological arousal. [4] [38]