My son, who is 10 y.o. with SWCAH, was switched from Cortef to Dex. because he was not doing well on the Cortef.  It has too short of a half- life.  In other words, as a short acting medicine, it was not caring him over from dose to dose...so he was having extreme difficulties with his mood, energy level, etc.  He was basically going in and out of an adrenal crisis because the Cortef was not holding him over to the next dose.  However, a word of caution...his lab work was coming back "normal".  The reason for this is his endo at the time only did blood drawls.   He blood was drawln within a couple of hours after receiving his Cortef.  However, once another endo did a 24-hour urine on him, it showed he was undermedicated.  He is now on dex. 1X/day and doing well!

Hope it wasn’t too wordy.....

Mary