Corticosteroids for multiple sclerosis
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How It Works
A high dosage of methylprednisolone may be given through a vein (intravenous, or IV) daily for 3 to 5 days during an MS attack. Prednisone or methylprednisolone may then be given by mouth for several days after the IV treatment.
Why It Is Used
Corticosteroids may be used to treat sudden, severe (acute) MS attacks and acute optic neuritis.
How Well It Works
Treatment with corticosteroids may reduce the symptoms of MS attacks and help you recover more quickly.1 There is no convincing evidence that corticosteroids can reduce the progression of MS.
Corticosteroids cause few side effects when used over a short period of time. People with MS who use a short course of corticosteroids to treat severe symptom attacks may have:
These problems will usually go away after you stop taking the medicine.
When corticosteroids are used in high doses or for longer periods of time, they can have more serious side effects, including:
- Weight gain and swelling in the face.
- High blood pressure.
- Blood sugar problems and diabetes.
- Weakening and thinning of bones (osteoporosis).
- Cataracts .
- Bleeding in the stomach and intestines.
- Lowered resistance to infection.
- Death of bone tissue caused by a restricted blood supply to the bones. This is most common in the bones of the shoulders and hips.
- Severe agitation, paranoia, and psychosis (if corticosteroids are used in very high doses).
The side effects that may occur with prolonged corticosteroid use can be a problem for people who have frequent MS attacks and need repeated treatment with corticosteroids.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
The safety of corticosteroids during pregnancy and breast-feeding is not well known. Talk to your doctor if you are planning a pregnancy, if you are pregnant, or if you are breast-feeding.
Intravenous (IV) corticosteroids may work faster and have fewer side effects than oral steroids alone. Treatment with IV methylprednisolone may be followed by treatment with oral prednisone or oral methylprednisolone. Toward the end of the treatment, increasingly lower doses are used so that the body can recover its own ability to produce natural corticosteroid hormones.
Some doctors like to use IV corticosteroids to treat MS attacks instead of using corticosteroid pills. This is because there is some evidence that corticosteroid pills may increase the risk for repeated attacks of optic neuritis. But this connection is controversial, and many doctors use corticosteroid pills to treat MS attacks too.
Corticosteroid treatment does not work for everyone. In some people who have severe or frequent attacks, corticosteroids are effective at first but become less helpful after repeated use.
Last Updated: February 18, 2010