8. Steroids

Corticosteroids

Corticosteroids, including cortisone, hydrocortisone and prednisone, are drugs that closely resemble the cortisol produced by the adrenal gland, and are commonly used in the treatment of asthma and other respiratory conditions, as well as arthritis and autoimmune disorders.

These drugs are known to prolong the QT interval (Busjahn 2004), and present increased an increased risk for arrhythmia.

It is recommended to calculate the half-life of steroid medication and for patients to cease consumption with sufficient time for the drug to be eliminated prior to treatment.

If corticosteroids must be used as an intervention (Ch. 15) during treatment, do so with caution.

Anabolic Steroids

Androgenic or Anabolic steroids closely represent testosterone and are available as prescription hormone treatments, however they are also often abused by body builders in order to facilitate rapid development of muscle tissue.

Patients who are taking anabolic steroids orally are prone to liver malfunction. Pay special attention to liver function tests.

For all anabolic steroids, get a prostate-specific antigen (PSA) test in addition to metabolism tests. Also, pay close attention to hemoglobin and hematocrit. A high blood cell count means patient is an increased risk for thrombosis, blood clots, heart attack. These patients also tend to have strong anxiety after treatment due to high blood pressure.

Patients should be counseled that this is a form of substance abuse.

If patient is taking testosterone correctly (shots, creams or gels), these should not be used during the day of treatment.

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