Dependency on Asthma Medications, specifically inhaled corticosteroids

[Sebastians Mom]

My 3 year old was diagnosed with Asthma over a year ago. We've been round about to several dr's before finally settling on one we feel has listened to us and been the most knowledgeable. This allergist retested him for allergies and found that dust and molds are his problems. We have since started immunotherapy for them. This Allergist took him off all his asthma medications because he felt that our son was over medicated (as did we). He was taking Pulmicort 5.mg BID, Xopenex 1.75 prn, and Serevent 2 puffs bid. At first my son seemed worse off the medications (he still continued on Ryna-12 S for allergies). When I questioned our new allergist on this he told us that some of the asthma medications can cause inflammation when taken away similar to over use of an OTC nasal decongestant spray.

I am just wondering if this is true (it sure seemed to be true in our case) and if so, why aren't more Doctors aware of this side effect. Our son was on most of those meds for over a year and most likely unnecessarily.

I'm curious if anyone else has heard of this or experienced it!
Thanks!

[National Jewish]

There is little information to support the concept of "rebound" from the use of inhaled steroids.  There are some reports discussing possible "rebound" with overuse of inhaled beta agonists.  This information is well documented in some people.  The most common finding was an increased hyperresponsiveness from overuse of the beta agonists.  This has not been described with the use of Serevent® (salmeterol).  However, there are few papers where it has been looked at in small children.  The studies showing a lack of rebound were all in adults.  Xopenex® (levalbuterol) is a relatively new beta agonist.  There are no specific papers on rebound with this agent.  However there is no reason to think it would not respond in the same way as other beta agonists.

[Concerned lady]

I've read that inhaled steroids can sometimes irritate the vocal cords (as can inhaled beta agonists like Albuterol), and this can lead to VCD (Vocal Cord Dysfunction) attacks (also known as "laryngo-spasm").

Carol
http://cantbreathesuspectvcd.com

[SSS]

Wanted to add my 2-cents on Serovent.  I tried it because I had not used any steroids for 2 years since my diagnosis with thyroid cancer!  (Steriods are a big "no no" for thyca patients.)  (Yes, I did "wean" off beclovent/flovent and relied on just albuterol alone.)  But, then in March '02, I got what seemed to me to be "bronchitis" tight chest, croopy cough, wheezing. lots of albuterol every day.  In response, Week 1, the doc gave Serovent Diskus.  I used it for two weeks -- calling the doc every 5 days to say I still couldn't breath only to be told, "you haven't given it long enough." Well, week 3, I ended up with pluerisy (sp?) -- 3 different spots-- in both lungs!  He finally gave me an antibotic (antibiotic) but didn't have me stop the Serovent.  I finally stopped it on my own 3 days later and began to feel much better.  That was March of '02.

This Autumn when I came in "early" suspecting "bronchitis" the doc gave me Singulair -- within 3 days I felt completely well!  It's amazing!  And, as long as I take it every night, my asthma is completely controlled -- no wheezing, no need for Albuterol.  I haven't breathed this well in YEARS!

[Sebastians Mom]

Thanks everyone! I guess there is just not enough studies on young kids. Really makes you question the medical industries willingness to over prescribe drugs. My son was doing Pulmicort .5 mg twice a day which is a steroid. Perhaps he was having irritation which caused the episodes. Because interestingly enough, his asthma episodes decrease signficantly since we stopped all the meds. Right now he's taking Zyrtec once a day and that's it. We do use Xopenex as needed but he's only needed it a couple times a month as opposed to a few times a week as he needed it before. He is also going for immunotherapy (allergy shots) so here's to hoping we reverse it by the time he goes to school!

thanks again!
Amy