From The MS Information Sourcebook, produced by the National MS Society.
Corticosteroids are hormones normally produced in the human body by the adrenal glands. They have a number of physiologic effects on different organ systems, but are most widely used for their anti-inflammatory actions.
Treatment for MS Attacks
Some corticosteroids, such as prednisone, are generally given orally. Others, such as methylprednisolone (Solu-Medrol®) and dexamethasone (Decadron®) are given intravenously (IV). Most MS specialists recommend a 3-5 day course of high-dose intravenous steroids as the treatment of choice for an acute MS attack-providing maximum benefit with fewest side effects. This treatment may require hospitalization, although it is common to have IV treatment on an outpatient basis. Depending on the physician's preference, the patient's condition, and the length of the treatment, the IV steroids may be followed by a one- to two-week tapering dose of oral steroids.
ACTH (adrenocorticotropic hormone), administered by injection, is also a recognized treatment for exacerbations of MS.
Treatment for Optic Neuritis
Steroids Should Be Taken Under Physician's Supervision
Oral steroids that have been taken over a period of time should never be stopped abruptly, since they can suppress the body's own steroid production by the adrenal gland. Gradually tapering the dose downward before discontinuation of the medication allows the body time to normalize production. Since a very short course of IV steroids has no effect on the adrenal gland, an oral steroid taper is not usually required.
Long-Term Use Is Not Indicated
The side effects of long-term continuous steroid use are serious and well-documented. These include stomach ulcers, weight gain, acne, cataracts, osteoporosis (thinning of the bones), deterioration of the head of the thigh bone, and chemical diabetes.
Last updated March 2006