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FYI, anti fatigue pill for HT treated PCAs . . . dexamethasone

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Posted 6/15/2013 4:47 PM (GMT 0)
I have been having trouble with fatigue this summer, brought about by the Lupron and Casodex therapy I've been on for six years. I saw my onc yesterday and she Rxed me Dexamethasone. The SEs are minimal as far as I can tell but a new broom yadayada. Just wondering if any of y'all have been Rxed this, it's the first AM that I've had a spring in my step in months.
It is a 5 mg dose, once a day, of a very mild corticosteroid. I'll let you know how I feel about it after a month or so . . . Q
Posted 6/15/2013 4:53 PM (GMT 0)
q,

let me know how this med works for you. been dealing with severe chronic fatigue since 2000, got much worse after my 2nd major radiation in 2009. may ask my dr. about next time we talk.

hope it helps you

david
Posted 6/15/2013 5:10 PM (GMT 0)
Will do David. this is the first day that I've be on my feet at 8:00 in over 8 months. I've been RXed dextroamphetamine for years but I hardly take it as the crash is too severe.This stuff is quite different . . . will keep you posted as I know we share some CP probs and the opioids we are forced to use sure don't help the fatigue. Best of luck . . . Q
Posted 6/15/2013 5:10 PM (GMT 0)
Will do David. this is the first day that I've be on my feet at 8:00 in over 8 months. I've been RXed dextroamphetamine for years but I hardly take it as the crash is too severe.This stuff is quite different . . . will keep you posted as I know we share some CP probs and the opioids we are forced to use sure don't help the fatigue. Best of luck . . . Q
Posted 6/15/2013 5:17 PM (GMT 0)
hi guys,I've tried dexamethasone and it does give a great lift to well being but it is an appetite stimulant and it made me ravenous all of the time so I don't take it unless I'm feeling very exhausted.It also creates a situation called moon face which makes the face and jowels seem to become quite rounded.I'm talking to my doc about trying Ritalin to decrease fatigue.
Posted 6/15/2013 5:46 PM (GMT 0)
Yeah, the SEs are a definite worry, google it and wiki has quite a list. I tried Ritalin but it was just too hars . . . clenched teeth and that old time Benzedrine feeling. If I were you, Lee, I'd give either adderallIR (mixed amphetamine salts) or dextroamphetamine a shot. They are both way cheap if that's an issue but I did find that I could only stand it twice a week due to hyperalgesia that it caused. Best of luck . . . Q
Posted 6/15/2013 5:52 PM (GMT 0)
Wife has chronic fatigue, tried all those stimulants. She'd rather be tired then deal with the side effects and I don't blame her. The side effects sucked.
Posted 6/15/2013 6:37 PM (GMT 0)
Quincy,
Dexamethasone (DXM) is a very potent steroid. Your 5 mg dose is equivalent to 30+ mg of prednisone. These are anti inflammatory drugs. Their action against fatigue is not without consequences. Weight gain, glucose intolerance and liquid retention among others like loss of bone density.

Don't take me wrong, DXM is known to be active in PCa. I am questioning the 5 mg dose. That is a pretty hefty dose. Maybe a lower dose should be tried first. Something in the order of 1 mg or two 0.75 mg might do the job.

RalphV
Posted 6/15/2013 7:02 PM (GMT 0)
Thanks Ralph, I think you've talked me into cutting these tablets in half and see if I get the same wake up. My fatigue level is such that I hardly ever bathe and am bedridden 80% of the time. Showers set off my hyperalgesia like mad as does getting in a tub. My wife gives good towel baths so I'm not a total stinkoid. I've made it through this battle for over six years with a lousy start so it's mainly QOL for me. I've had some funky experiences with prednisone so I know what SEs to watch for if I have to give this stuff the boot like I have other stimulants. I just would like to get up and play with the other kids sometimes though. Your info was invaluable, thanks good buddy . . . Q
Posted 6/15/2013 7:10 PM (GMT 0)
Zufus had 2 threads on dexamethasone and prostate cancer. This is one of them:

www.healingwell.com/community/default.aspx?f=35&m=2731045

This is a related thread: www.yananow.org/display_story.php?id=1272
Posted 6/15/2013 7:34 PM (GMT 0)
I am very, very allergic to prednisone, wouldn't like to be on any med that even resembles that stuff. Even though I have been on heavy amounts of opiates the past 2 years, can honestly say that the meds themselves didn't really increase my chronic fatigue issues, as they have been intense for years on their own. It was going through 2 major bouts of radiation in a 10 year period that set the scene for the fatigue.

However, the severe chronic pain I have been fighting the past 2 years has had a direct toll in increasing my fatigue levels, fighting pain does a number on the body, and since the scope of the pain is still on the rise with me, even more fatigue has set in. Kind of a vicious circle effect
david
Posted 6/15/2013 7:41 PM (GMT 0)
Quincy, I don't think I would go ahead and cut the dose in half. If this dexamethasone is anything like prednisone, you have to be systematically weaned off the dosage. Believe it or not, I have a cat is on long term prednisone (2.5 mgs. every 48 hours) but she started out on a much higher dose. The vet gave us clear, written instructions on how to bring her down to the 2.5 mg. every other day...it's not something you just 'do' and we were told stopping or changing her dose drastically could result in cardiac arrest. These are not drugs to fool around with but they definitely have their purpose.
Posted 6/15/2013 7:44 PM (GMT 0)
I agree with Sephie, Quincy. I wouldn't reduce or cut in half without your doctors full consent and advisement. I would err on the side of safety until you can contact your doctor
Posted 6/15/2013 7:48 PM (GMT 0)
Quincy,
Not a good idea to reduce dose abruptly. Talk to your doc about it. There is a set process. Do not fool with it.

RalphV
Posted 6/15/2013 8:42 PM (GMT 0)
Ralph- good points and Dexamethasone to Prednisone is 6-7 times the equivalent dose (I hear), so 5 mg of it is very high= 30 to 35 mg of prednisone which is plenty. Talk to the doc, but likely you can wean yourself down in doseage over a few days or a week and maybe get results with 1 mg, which is likely not even noticeable side effects, too. Either drug you cannot just quit, weaned off of them only and not to be ignored.

Now the protocol I referred to (Robert-mentioned w/link), is for a PCa treatment concept for people with disease levels that are not way out of hand or control, and for some in that category it seems to give them better psa results, from our limited collected data on just a few patients (kind of like a clinical trial by just few guys whom tried it). Not sure if it makes a big difference in PCa side effects, but it might.
Posted 6/15/2013 9:23 PM (GMT 0)
I guess I didn't make myself clear on my OP, today is the first day that I've taken a dexamethasone so now is the time to cut the dosage, don't you think? maybe even down to a 1/4 tablet. Thats why I brought y'all this topic today so that you fine folks could steer me clear on what you know. The first thing I did, even before taking one this AM was research it online and then write this topic. You folks are soo wonderful with your speedy and knowledgeable replies, I just love that!
I have twice taken six day courses of prednisone so I am somewhat familiar with its SEs and I did not like them, no, not one bit. But that was a higher dosage than the 5 mg that I took this AM. I think that the pharmacy could have made a mistake as the nurse practitioner, who is the sharpest knife in the dishwasher, told me, I'm pretty darn sure, that the dosage was going to be 1 mg, not 5. I'll be talking to her Monday and I'll bet. that she will be relieved that I took your advice.
Just this one dose feels mighty strong to me and I've been through the gauntlet on every type of analgesic, from amitriptyline to Fentora. Thank you soo much for your concerned responses everyone! I sure hope that I can get this wake up at 1.25 mg as this fatigue is the worst part of my battle,but if it isn't, tough luck, I will not risk taking something, especially a corticosteroid in such a heavy concentration . . . Q
Posted 6/16/2013 5:06 PM (GMT 0)
Quincy, steroids interfere with the pituitary gland...in effect, they shut it down and the meds 'take over' doing what the gland does. I cannot stress strongly enough the importance of speaking with your doctor before you adjust the medication, even if you've only taken it for 24 hours. Seriously, these are powerful drugs that can be quite dangerous if used improperly - and cutting the dose voluntarily without your doctor is dangerous.

Read Zufus' post stating that dexamethasone is much stronger than prednisone (his post said 6 to 7 times strong), so 5 mg. is a high dose of steriods. Please speak with your doctor first.
Posted 6/16/2013 8:33 PM (GMT 0)
I take your advise quite seriously and went ahead and took the Drs' full dosage this AM. will be talking to her tomorrow. It is so nice to have an onc on call, so to speak. Dr. Karen is always ready to answer her patients calls, so much different from my previous name Dr. here. And I want to thank you too, for your concern. I am familiar with steroids effects on both the pituitary and the adrenal glands as well as the adrenal glands production of testosterone so I am being extra careful due to your and Zufus strong advice. I realize that you folks aren't Drs. but experience is an awfully good school . . . Q
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