Treating MS Relapses With Solu-Medrol

What You Should Know About This Powerful Medication

Healing from Your MS
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For someone with relapsing-remitting multiple sclerosis (RRMS) who experiences a serious relapse of symptoms, the go-to treatment usually is a corticosteroid. These are drugs that mimic a hormone that's naturally produced by the adrenal glands to relieve inflammation (redness, swelling, pain). In the case of an MS relapse, corticosteroids reduce inflammation in the central nervous system—inflammation that leads to bouts of MS symptoms such as eye pain or vision problems, muscle weakness, and trouble balancing.

Do You Need Solu-Medrol?

Often, the corticosteroid of choice for treating severe MS relapses is a drug called Solu-Medrol (methylprednisolone). (Note that sometimes a doctor will prescribe this drug for someone who has a symptom such as pain that's been getting worse and worse over time, has progressed to the point of being intolerable, and hasn't gotten better with other treatments.)

Solu-Medrol is a powerful medication, and it's not without side effects, so it's important to make absolutely certain it's necessary. For example, it needs to be clear that an actual MS relapse is in progress. If you think that may be happening to you, here are some things to ask yourself about what you're experiencing. If you answer yes to these questions, you may well be having a relapse.

  • Am I having new symptoms or are symptoms I already have getting worse?
  • Has this been happening over the course of 24 hours to a couple of days?
  • Have these symptoms lasted more than 24 hours?
  • Has it been at least a month since my last relapse? (In other words, have these symptoms been non-existent or stable for at least 30 days before they appeared or got worse?)

To confirm you're having a relapse or to rule it out, your doctor may do an MRI. It turns out that many people with MS, especially those in the early stages of RRMS, have few active lesions happening all the time.

These are the lesions that “light up” in the presence of gadolinium (a contrast agent used for MRI scans) for about six weeks, then fade as the inflammation recedes. When an MRI shows very few such lesions are causing symptoms, and certainly not causing symptoms dramatic enough to apply the word “relapse” to the situation, Solu-Medrol probably isn't needed.

Taking Solu-Medrol

When this medication is given to treat an MS relapse, it's usually given intravenously—that is, through a needle directly into a vein—over the course of three to five days. For many people, Solu-Medrol can bring an enormous amount of relief from a relapse. Some have found that after just one infusion of the drug, MS symptoms that were debilitating become manageable, or even disappear altogether. At the very least, within two or three days of a course of Solu-Medrol most people report that their symptoms are much better.

Regardless of what it's used for, Solu-Medrol is not without side effects, such as sexual problems and weight gain, so in some cases it might be better to wait out a relapse (if you can tolerate the symptoms or get relief from another treatment). By not taking Solu-Medrol you won't be at risk of permanent damage or residual effects of soldiering through the relapse, and you will avoid the side effects.

You might also ask your doctor about taking Solu-Medrol in a tablet form, rather than by infusion, which may cut down on side effects. There's preliminary research to show that oral methylprednisolone can be just as effective in relieving an MS relapse as infusions.

Sources:

E le Page, et al. "Efficacy and Safety of Oral Versus Intravenous High-Dose Methylprednisolone in Multiple Sclerosis Relapses, A Randomized Double-Blind Trial (COPOUSEP)." Lancet. 2015 Sep 5;386(9997):974-81.

Olek MJ. "Treatment of Acute Exacerbations of Multiple Sclerosis in Adults." UpToDate2016.

Ontaneda D & Rae-Grant AD. Management of Acute Exacerbations in Multiple Sclerosis. Ann Indian Acad Neurol. 2009 Oct;12(4):264-7.

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