Can prednisone (corticosteroid) cause hyperesthesia (increased sensitivity of the senses)?

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From the Guidelines

Prednisone can cause hyperesthesia as a side effect, although it is not explicitly listed among the potential adverse effects in the provided evidence. Hyperesthesia is an increased sensitivity to sensory stimuli like touch, pain, or temperature. This neurological side effect may occur during prednisone treatment due to the medication's effects on the nervous system and its influence on neurotransmitter function, as suggested by the potential adverse effects of oral systemic corticosteroids, including mood alteration and other neurological effects 1. Patients taking prednisone who experience unusual sensory sensitivity, tingling, or heightened pain responses should report these symptoms to their healthcare provider. The risk of experiencing hyperesthesia may increase with higher doses or prolonged treatment courses, as seen with other side effects like adrenal axis suppression, growth suppression, and dermal thinning associated with long-term use of prednisolone, a similar corticosteroid 1. These sensory disturbances typically resolve after discontinuation of the medication, though tapering rather than abrupt cessation is important to avoid withdrawal symptoms. Other neurological side effects of prednisone can include mood changes, insomnia, and in some cases, more serious effects like psychosis, particularly at higher doses.

Key Points to Consider

  • The provided evidence does not directly mention hyperesthesia as a side effect of prednisone but does list various potential adverse effects associated with oral systemic corticosteroids 1.
  • The mechanism of corticosteroids like prednisone can influence the nervous system, potentially leading to neurological side effects including hyperesthesia.
  • Monitoring for unusual sensory sensitivity and other neurological side effects is crucial during prednisone treatment.
  • Dose and duration of treatment can impact the risk of side effects, including hyperesthesia.
  • Tapering the dose upon discontinuation is recommended to avoid withdrawal symptoms.

Clinical Implications

Given the potential for prednisone to cause hyperesthesia, healthcare providers should be vigilant for signs of increased sensory sensitivity in patients undergoing treatment with this medication. Early recognition and management of such side effects can improve patient outcomes and quality of life. The decision to use prednisone should be made with careful consideration of the potential benefits and risks, particularly in patients with a history of neurological or psychiatric conditions 1.

From the FDA Drug Label

Dermatologic acne, acneiform eruptions, allergic dermatitis, alopecia, angioedema, angioneurotic edema, atrophy and thinning of skin, dry scaly skin, ecchymoses and petechiae (bruising), erythema, facial edema, hirsutism, impaired wound healing, increased sweating, Karposi’s sarcoma (see PRECAUTIONS: General Precautions), lupus erythematosus-like lesions, perineal irritation, purpura, rash, striae, subcutaneous fat atrophy, suppression of reactions to skin tests, striae, telangiectasis, thin fragile skin, thinning scalp hair, urticaria Neuropathy, paresthesia

The answer is no, prednisone is not directly associated with hyperesthesia (increased sensitivity of the senses) according to the provided drug label 2. However, it can cause neuropathy and paresthesia, which may be related to abnormal sensations but are not the same as hyperesthesia.

From the Research

Adverse Effects of Prednisone

  • The provided studies do not directly mention hyperesthesia (increased sensitivity of the senses) as a side effect of prednisone treatment 3, 4, 5, 6, 7.
  • However, the studies do report various adverse effects associated with prednisone use, such as:
    • Fluid retention or bloating, and insomnia 3
    • Avascular necrosis, gastrointestinal bleeding, myocardial infarction, heart failure, cerebrovascular events, diabetes mellitus, psychiatric syndromes, ophthalmic complications, tuberculosis reactivation, and bacterial sepsis 4
    • Pre-diabetes, weight gain, bruising, irritability, osteoporosis, and osteopenia 6
  • The studies suggest that the risk of adverse effects increases with higher doses and longer duration of prednisone treatment 4, 6, 7.

Specific Side Effects

  • None of the studies specifically mention hyperesthesia as a side effect of prednisone treatment.
  • The studies focus on more common adverse effects, such as those related to metabolic, cardiovascular, and musculoskeletal systems 3, 4, 6, 7.
  • Local anesthetic and steroid use in regional anesthesia and pain treatment are discussed in one study, but hyperesthesia is not mentioned as a side effect 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Complications of Corticosteroid Therapy: A Comprehensive Literature Review.

The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians, 2022

Research

Adverse Side Effects Associated with Corticosteroid Therapy: A Study in 39 Patients with Generalized Myasthenia Gravis.

Medical science monitor : international medical journal of experimental and clinical research, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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