Prescription,
Procedure, Results
How do I get it prescribed? What do I need to do
before treatment starts? What is the general procedure
for treatment? What results should I expect to see?
After diagnosis of autism, see a neurologist specializing
in autism. The doctors listed
here have experience in using prednisone as a treatment,
and you may contact them to make an appointment.
Your neurologist will usually do a medical baseline
to rule out other disorders:
- Blood work (Chromosomes, DNA for fragile X, lead
level, quantitative amino acids and organic acids,
among others)
- MRI (tumors, tubercular sclerosis, encephalitis..)
- 24-hr EEG (Landau-Kleffner Syndrome & variants…)
Your neurologist will usually work with other specialists
to establish a developmental baseline, in order to measure
progress:
- Speech pathologist to establish language baseline.
- Psychologist / psychiatrist to establish behavioral
baselines.
- Child’s regular pediatrician to establish physical
condition & monitor overall medical progress.
- Your neurologist will develop prescription in consultation
with you, the child’s pediatrician and other
specialists. The role of your child’s pediatrician
cannot be overstated; you must keep him or her "in
the loop" at all times.
Neurologists usually follow one of two protocols:
- Daily protocol: Typically 2-3 mg / kg in liquid
or pill form, each morning or twice a day. This is
continued for about two months, and may be followed
by a two-month period of low-dose (every-other-day).
The child is then weaned off the prednisone in ever-decreasing
quantities for about two months.
- Pulse protocol: Typically 10 mg/kg per week in pill
or suppository given over over 24 hours, every 4 or
5 days; or a dose of 50-75 mg Friday and Saturday--
max. 100 mg Friday and 100 mg Saturday. This is continued
over a period of several months. The child is then
weaned off the prednisone in ever-decreasing quantities
for several months.
Tests & doctor’s visits:
- Daily protocol: Weekly blood pressure (at pediatrician’s
office) and urine glucose (can be done at home); bi-weekly
potassium levels (blood draw at pediatrician’s
office).
- Pulse protocol: Regular blood-pressure (at pediatrician’s
office). Lab functions (urine glucose & blood
electrolytes) every 1-3 months.
It may take 4-8 weeks for improvements to begin. In
some cases, adverse behavioral reactions may happen
for a month or more and cause the appearance of regression,
before improvements begin
You need to follow the child’s progress. You should
have a speech/language evaluation done about halfway
through the treatment, then shortly after treatment
ends. If the original EEG showed abnormalities, follow-up
EEGs should be done. This information will provide a
concrete basis to determine how the treatment helped.
Most children will show significant progress in verbal
communication - if there was no language to start, a
sudden burst of speech, sometimes a few more words each
week, others a rapid growth. Another possible outcome
is that the child does not show verbal improvement but
improves in other communications, e.g., reading, writing,
signing. In some cases there is no improvement.
Partial regression may occur during later phases of
treatment or after treatment ends. In some of those
cases, a second course of prednisone may be advised.
It is vital that other interventions, notably behavioral,
speech and physical therapy, be continued during treatment.
Questions or comments about Prednisone and Autism?
Email us at prednisone@aheadwithautism.com.
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Prednisone
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