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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> FR - Single High Dose of Steroids
        
(Message started by: floridian on Mar 20^th, 2005, 8:41pm)

Title: FR - Single High Dose of Steroids
Post by floridian on Mar 20^th, 2005, 8:41pm

A single high dose of corticosteroids provides an average of 4 days relief. For roughly 1/4 of episodics it broke the cycle. This method may have fewer side effects than the normal taper, although it is less effective. Glad they are trying new things and making careful notes.

Quote:

Cephalalgia. 2005 Apr;25(4):290-5.

Single high-dose steroid treatment in episodic cluster headache.

Antonaci F, Costa A, Candeloro E, Sjaastad O, Nappi G.

Department of Neurological Sciences, IRCCS C. Mondino, University of Pavia, Pavia, Italy.

Antonaci F, Costa A, Candeloro E, Sjaastad O & Nappi G. Single high-dose steroid treatment in episodic cluster headache. Cephalagia 2004. London. ISSN 0333-1024 Corticosteroids appear to be the most rapid-acting of the prophylactic drugs used in the treatment of cluster headache (CH). These agents are frequently employed as a short-term regimen to induce clinical remission. In this study, we assessed in an open fashion the effect of high dose methylprednisolone (MPD) in a group of 13 patients with episodic CH (3 females and 10 males). On the 8th day of the active period, MPD was administered intravenously at the dose of 30 mg/kg body weight, as a 3-h infusion in saline. The attack frequency was followed for 7 days. The mean daily attack frequency before MPD administration was statistically different from that reported after treatment (respectively: 1.38 +/- 0.42 and 0.83 +/- 0.78; P = 0.05 Student's t-test). The mean interval between MPD administration and the occurrence of the first subsequent attack was 3.8 +/- 2.2 days (range: 2-7 days). Only 3 (23%) of 13 patients experienced a complete headache remission. No significant side-effects were noted after MPD administration. These data further demonstrate that in most patients with episodic CH, high-dose systemic steroid administration may invariably interrupt attack recurrence for a few days, but is ineffective in maintaining complete clinical remission. This study also suggests that MPD administered as a solitary dose does not provide any advantage above prednisone in CH treatment.

Title: Re: FR - Single High Dose of Steroids
Post by Lizzie2 on Mar 20^th, 2005, 9:05pm

OK so...right now I'm seriously lacking the mental capacity to dig through the science, etc. However, is this similar to when I used to go in the hospital, and I'd get IV solumedrol? They didn't just do it once...I think they could do it for a max of a few days.

I know it used to raise my sugars quite a bit, and I don't know how it contributed to the AVN (if at all), but I don't think Jefferson is doing it in the inpatient setting anymore due to finding some more about steroids and AVN. I could be wrong, but that's what I heard.

I know they won't give me steroids anymore...in fact they've listed it as an allergy, and when I had my surgery on the 8th, they didn't want to use decadron as part of the surgery just in case.

Title: Re: FR - Single High Dose of Steroids
Post by floridian on Mar 21^st, 2005, 8:19am

If someone has AVN or is at high risk for it, steroids are not an attractive option.

I'm not sure about a single high dose of steroids and AVN. I know several years ago, there was lots of talk about alternate day therapy, or third day therapy. The idea was that the adrenal cortex would not be as likely to shut down the corticosteroid production if the external meds were given less frequently. But for AVN, it could be different - it could be that the blood levels are as/more important than the duration.

Title: Re: FR - Single High Dose of Steroids
Post by don on Mar 21^st, 2005, 8:37am

High dose and low dose can be effective for me. I have had only one prolonged cycle in the last 4 years at which time I employed the high dose taper to break it.

Although cycle free I have not been pain free. The occassional unexpected attack occurs.

That overall sick and knowing feeling of an oncoming cycle also occurs. Thats when a low dose has been effective. I found that a single 20 Mg dosage of pred. daily has prevented the cycle from continuing.

Quote:

A single high dose of corticosteroids provides an average of 4 days relief.

So a single low daily dose seems to have produced the same benefits as above. Will it work for everyone? I doubt it. Will it work for me on the next approaching cycle? Remains to be seen.

Title: Re: FR - Single High Dose of Steroids
Post by unsolved1 on Mar 21^st, 2005, 10:47am

Steriods, you gotta love em'. With me, it's a love-hate relationship. I just finished up a Medrol Dose Pak. mmm good! I've also done Solu Medrol many times. Once for 11 days straight in the hospital (I gained nearly 50 lbs)

I use steriods when i'm about to 'lose it' . It is effective.

Unsolved

Title: Re: FR - Single High Dose of Steroids
Post by pubgirl on Mar 21^st, 2005, 4:10pm

Thanks Jonathan for this. There are some VERY obvious advantages to this approach. Will copy this post over the pond if it is OK with you, which will reinforce your deity ;;D

Dubya da Bee