My son had bad experiences using pred... it made him very depressed, there again he did not get on well on dex, he had terrible weight gain and acne.  Both pred and dex have a much longer life and are so much more potent than hydrocortisone. In my opinion, it seems that as soon as levels go up, doctors increase the dose without looking at how long the medication is lasting in the body, which leads to weight gain and other side effects.  I believe in 24 hour profiles, not one off blood tests, so medication can be fine tuned as to how the individual needs it.  It seems more and more thought provoking, that people using this board have achieved the best growth, weight control and level control by following the circadian rhythm, in not in 2 - 3 doses a day but 4. Hydrocortisone is the natural replacement for cortisol and if given correctly, the right dose, at the right time for the individual would surely have the least side effects?