How to Manage Multiple Sclerosis Relapse: The Use of Solumedrol

For severe exacerbations (involving loss of vision, severe weakness or poor balance, for example), which interfere with a person’s mobility, safety, or overall ability to function, neurologists may recommend a short course of high-dose corticosteroids to reduce the inflammation and bring the relapse to an end more quickly. The most common treatment regimen is a 3-5 day course of intravenous Solu-Medrol® (methylprednisolone). High-dose oral Deltasone® (prednisone) may also be used.

Most people are able to receive IV treatment on an out-patient basis, either at home or in a doctor’s office. In some situations, hospitalization may be recommended or required. 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.  Corticosteroids, however, are not believed to have any long-term benefit on the disease.

Corticosteroids should always be taken under a doctor’s supervision. Possible side effects include stomach irritation, elevation of blood sugar, water retention, restlessness, insomnia, and mood swings. Most patients tolerate the treatment well. Even with short courses of IV steroids, the physician may need to prescribe medications to help the person sleep and minimize stomach discomfort.

For 10 tips on how to make the Solumedrol experience go more smoothly, see Beginner’s Guide to MS: Solumedrol, It’s All the Rage!!!

Any Precautions When Using Steroids?

Corticosteroids can stimulate the appetite and increase water retention, so follow a low-salt and/or potassium-rich diet and watch your caloric intake.  They may also affect the blood sugar levels of diabetic patients. If you notice a change in your blood or urine sugar tests, be sure to speak to your doctor.

Steroids can lower your resistance to infection and make any infection you get more difficult to treat. Contact your doctor if you notice any sign of infection, such as sore throat, fever, coughing, or sneezing.  Avoid close contact with anyone who has chicken pox or measles.  Do not have any immunizations after you stop taking this medication until you have consulted your physician. People living in your home should not have the oral polio vaccine while you are being treated with corticosteroids since they might pass the polio virus on to you.

The risk of birth defects for women taking corticosteroids is not known. Overuse of corticosteroids during pregnancy or breast feeding while on steroids may slow the growth of the infant. Animal studies have demonstrated that corticosteroids cause birth defects and it may be necessary for you to stop nursing while taking this medication.

Corticosteroids may produce mood changes and/or mood swings of varying intensity. These mood alterations can vary from relatively mild to extremely intense, and can vary in a single individual from one course of treatment to another.  If you have a history of mood disorders (depression or bipolar disorder, for example), be sure to share this information with your doctor. If you begin to experience mood changes or swings that feel unmanageable, contact your doctor so that a decision can be made about whether or not you need an additional medication to help you until the mood alterations subside.