Steroid Dosing Questions

[perljen]

It took years for me to get a proper diagnosis despite lesions appearance on MRI four years ago.
My new neuro wants to start me on a steroid to clear up an exacerbation that's been going on for two months. My mom used steroids non-stop for years. She began having compression fractures. Pain management did not even work after awhile. She ultimately died of a heart attack brought on by pain of osteoporosis. My questions are: what are typical dosing schedules and how long would it take for the steroid to clear this setback?

[NHE]

A commonly used protocol is to receive methylprednisolone by IV once a day for 3 days.

An oral prednisone taper following the 3 days of IV used to be popular years ago, but it doesn't seem to be so common anymore.

[perljen]

Thank you for responding. I should have mentioned that w/my old neuro I was hospitalized for a five-day course of the medication you sited. The first afternoon home the problems I went into hospital for returned. Could you tell me on a steroid what dosages are used? Thanks for your time.

[Snoopy]

Hi perljen,

IV steroids are usually 1000mg for 3 to 5 days.

Steroids are used for exacerbations (relapse, attack, flare-up) however not all exacerbations require steroids. An exacerbation has the ability to resolve on it's own. Steroids do not change the out come of the disease but might resolve the exacerbation sooner, but not always. The more steroids are used the less effective they become. Steroids are no longer given non-stop as in your mother's case. Steroids are not used for symptom management, there are symptom management medications.

An exacerbation is a worsening of old symptoms and/or new symptoms lasting continuously for more than 24 hours and separated from the previous one by 30 days. Remission in MS is either complete (no symptoms) or partial (residual symptoms), Partial being the most common. All this means is you are not doing as bad as when the exacerbation started. If you have seen any improvement since the exacerbation started then it is very possible you are experiencing what is referred to as remission.

Steroids have short term and long term serious side effects which is what your mother experienced. Some of the long term side effects of steroids:
- Cataracts
- Cushing's Disease
- Diabetes
- Glaucoma
- Avascular Necrosis
- Osteoporosis

[Scott1]

Hi,

The issue will be what the symptoms are. Not everything is fixed by that method. Long term use of steroids is a problem. If it taken the way you have suggested then its a global answer to what might be a local problem.

By all means use a short course to create a circuit breaker but the question should always be "what are you trying to do?".

The fact that you say your symptoms returned quickly after the earlier IV treatment suggests it may not have been the right thing. Perhaps you could go into more detail about what the symptoms are and what other medication you are using.

Regards,