My 4 year old son has been on high dose prednisone since Feb 09. He relapses very quickly when we have attempted weaning. He currently is on a trial of Cytoxan (started 5 days ago) + is continuing prednisone at 10 ml/day (which is around 32 mg/day) for 4 weeks despite his current remission; the doctor wants to maintain remission for the cytoxan trial.
My issue is with some terrible, frightening behavioral outbursts. He has not had anything to this degree until about 1 week ago when he began to blow up at every little thing and had noticable difficulty getting settled down afterward. These have progressed into meltdowns multiple times a day that include kicking, hitting and biting. I have resorted to putting him in his room and holding the doorknob until he calms down but now he is also breaking things and being destructive while in these rages. It takes at least 30 minutes for him to calm down and he may later have another episode just like it later in the day.
He has always been a bit moody but never like this. In the past (including for the last 6 months on prednisone) he has always managed to control his behavior and has had no problems in preschool or in public, and rarely even with me at home.
Is there anything that can be done to mitigate the behavioral side effects of prednisone? We can not go to every other day dosing because he relapses so fast; we are trying a slow monthly reduction in his dose. I am not sure I can keep going with this for much longer; he's almost psycotic in his raging. Last night he even woke up in the middle of the night screaming and having a fit. I have called the doctor and am waiting to hear back but would appreciate some advice from anyone who's been there in the meantime.