These can include but are not limited to:The main risk when taking doxepin is antidepressant discontinuation syndrome, which is a condition that can occur when the use of antidepressant drugs is stopped or dosages are reduced. Using ICS especially in high doses for a long amount of time can lead to an increased risk of side effects such as: • Pneumonia • Development of diabetes • Osteoporosis and fractures • Cataracts • Behavioural effects, e.g. N Engl J Med 335 (1996): 841-734. If you already use a metered dose inhaler, symptoms may be reduced if you use a spacer or chamber device, which is attached to the inhaler. This is not a complete list of side effects and others may occur. The result is adrenal insufficiency, which can be treated with medication to replace cortisol or aldosterone.Dekkers and colleagues analyzed 74 research articles published from 1975 to 2014, covering a total of 3753 study participants, to see how different doses and types of corticosteroid treatment might impact the likelihood of developing adrenal insufficiency after treatment.Researchers found the risk of adrenal insufficiency was highest when corticosteroids were taken orally or injected, and lower with inhaled, nasal or topical treatment.When they looked just at patients using steroids for asthma, the researchers found that the risk of adrenal insufficiency was about 7 percent with inhaled corticosteroids, but about 44 percent with other formulations including oral medication.Only about 2 percent of asthma patients on the lowest dose of steroids experienced adrenal insufficiency, compared with about 22 percent on the highest doses.Similarly, slightly more than 1 percent of asthma patients on short-term steroids developed adrenal insufficiency, compared with about 27 percent on long-term treatment.There is no way to safely halt treatment with corticosteroids that can rule out the potential for adrenal insufficiency, Dekkers said.The side effect is more likely when patients take higher doses of steroids or remain on treatment for longer than three weeks, said Dr. Roberto Salvatori, medical director of the pituitary center at Johns Hopkins Hospital in Baltimore.“It’s likely, and it’s often overlooked because most often the people who prescribe corticosteroids aren’t endocrinologists; they are in other specialities and they don’t recognize the symptoms of adrenal insufficiency,” said Salvatori, who wasn’t involved in the studyHe gives his patients on corticosteroids medical identification bracelets or necklaces to wear so they can be identified as at risk for adrenal insufficiency in an emergency. Liem EB, Mnookin SC, Mahla ME "Albuterol-induced Lactic Acidosis." “This is a very important issue that’s not on the radar screen,” he said.To be sure, more physicians are aware of the risk now than in the 1970s, and the standard doses and durations of corticosteroid treatment have been reduced in part because of this risk, said Dr. Douglas Coursin, a professor at the University of Wisconsin School of Medicine and Public Health in Madison. Mettauer B, Rouleau JL, Burgess JH "Detrimental arrhythmogenic and sustained beneficial hemodynamic effects of oral salbutamol in patients with chronic congestive heart failure." These undesirable effects may subside on continuation of treatment.1. When you overuse ventolin, you’re essentially replacing your body’s natural defenses against asthma, increasing your dependency on the inhaler as well as frequency of use. If you notice side effects of albuterol or your asthma isn’t well controlled, talk to your doctor about how and when you’re taking it. Some people get: a sore mouth or throat ; a hoarse or croaky voice ; a cough Doxepin is not a controlled substance, but a psychological dependence can form if the drug is misused, putting you at a higher risk for side effects and withdrawal symptoms. Hastwell G, Lambert BE "The effect of oral salbutamol on serum potassium and blood sugar." Svedmyr N, Lofdahl CG "The use of beta(2)-adrenoceptor agonists in the treatment of bronchial asthma." Withdrawal symptoms are probably much more likely with the high dosages of doxepin used to treat depression and anxiety, and much less common with the low dosages used to treat insomnia. SIDE EFFECTS. Kantola I, Tarssanen L "Hypokalemia from usual salbutamol dosage ." Cerner Multum, Inc. "UK Summary of Product Characteristics." This can help avoid unpleasant side effects (withdrawal symptoms), such as severe tiredness, joint pain, being sick and dizziness.