Introduction

This information is for people who have multiple sclerosis. It tells you about steroids, a treatment used to help symptoms during a relapse of multiple sclerosis. It is based on the best and most up-to-date research.

Do they work?

Yes. If you have a relapse of MS symptoms, steroid tablets or injections may make you feel better.

Although steroids help to treat a relapse, they don't have long-term benefits. So, they won't stop you having another relapse or affect how disabled you become.

Steroids are the standard recommended treatment for MS relapses in the UK.^[2]

What are they?

Steroids are drugs that reduce inflammation. Doctors call them corticosteroids. They're used to treat many conditions that cause inflammation, such as arthritis and asthma. They're not the same as the anabolic steroids that some bodybuilders use.

You can have daily tablets or injections of steroids. In the studies, people took steroids for up to about 15 days.

• The steroid doctors use most in MS is called methylprednisolone. Usually it's given as an injection into a vein. The brand name is Solu-Medrone.

• Your doctor may also give you methylprednisolone tablets (brand name Medrone).

How can they help?

If you're treated with a steroid when you have a relapse, there's a good chance that you will recover faster than if you didn't have this treatment.

Symptoms get milder in about 65 in 100 people with MS who take a steroid to treat their relapse, compared with 40 in 100 of those who don't take anything.^[74] It doesn't seem to matter whether you take steroids for five days or 15 days.

But taking them won't stop you having more relapses.

How do they work?

Steroids reduce the inflammation around nerves in your brain and spinal cord. This should help your nerves heal and work better, so that signals move more smoothly along them. As a result, your symptoms should get better. (To learn more about what happens in MS, see What is multiple sclerosis?)

Can they be harmful?

Yes. Minor side effects are common with steroids.^[2] They can also cause serious side effects. Harmful effects are more likely if you take steroids for a long time. They are less likely with the short courses you take for a relapse of MS symptoms.

Side effects of steroids include:^[2]

• A risk of infections, such as chickenpox

• Weak bones that break more easily

• Weight gain

• An upset stomach.

Steroids can also cause high blood pressure and raise the amount of a sugar called glucose in your blood.^[2]

About 1 in 20 people find that steroid tablets affect their mood.^[75] This can happen a few days or weeks after you start treatment. You may be irritable, anxious, confused, or have trouble sleeping. Or you may get an unusually high mood (euphoria). Rarely, people get more serious side effects, such as thinking about suicide or seeing things that aren't really there. It's also possible to get these side effects when you stop taking steroids.

Your doctor should explain the benefits and risks of steroids before you start taking them. If you get any worrying symptoms while you're taking steroids, see your doctor straight away.