What causes severe asthmatic attacks post Symbicort withdrawal?
Patient: I was taking Symbicort for 2 months, and my asthma was the best it has ever been ever. Prior to that I used to wake up every night from asthma having to take my ventolin. I never needed to use my ventolin since I was on the Symbicort which was great. But I was a bit silly and didnt realise my symbicrt inhaler ran out, so my asthma got really bad to the point where I couldn't go to work, and when i took my ventolin it appeared to no longer work on me. Could I be having withdrawals from the Symbicort? Or could it be that I hadn't taken the ventolin for so long that my body doesn't want it anymore? Doctor: Hello,Thank you for asking at HCM.I went through your history and would like to make suggestions for you as follows:1. To address your main queries - withdrawals from Symbicort? - one can say that in common man's terms, but actually it is not withdrawal in scientific sense. (as explained in No 2).Body does not need Ventolin anymore - it is not a correct interpretation.2. Asthma is a chronic disorder. Most of the "controller drugs" for asthma (such as Symbicort) actually only "control" the symptoms of asthma but cannot "cure" asthma. So when one stops such controlled medications, one experiences return of asthma symptoms.3. Ventolin is a "rescue" type of drug. It is to be used only for symptom relief when symptoms occur. However, frequent intake of such medications is not desirable, so in that case one needs to take "controller" type of inhalers on regular basis. This is as happened in your case.4. I usually my such patients to take minimum dose of "controller" medications regularly that controls all their asthma symptoms. For example, I would suggest my patient regular inhaler (like Symbicort) and montelukast. In addition, I would suggest him to take salbutamol inhaler on as-and-when-needed  basis.5. Were I treating you, I would also suggest you allergy testing for common air-borne allergens like house dust mites, molds, pollens, insect proteins, pet dander (if you have pet) etc. This will help you identify substances causing allergies to you as well as to know the measures to avoid them.6. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works gradually on immune system to improve allergy symptoms on a long term basis.7. Regular breathing exercises and a healthy nutrition will also help you in a long run by improving your lung capacity and immunity respectively.Hope above suggestions will be helpful to you.Should you have any further query, please feel free to ask at HCM.Wish you the best of the health ahead.Thank you & Regards.