I've not had that many episodes that I needed IVSM but I have always had a Prednisone taper. With this episode of ON I did not. So on this first day since the IVSM is over I just feel so blah, no energy. Coyuld some one lead me to an article of benefit of no taper VS taper

I have never had a taper. I too would like to see the research. I have always been unplugged and sent home.

I always had a taper, but I knew that some Docs were eliminating it, as unnecessary. I have no idea why or what made them come to that conclusion. Ask your Doc!

EDIT...I found this:
http://www.ncbi.nlm.nih.gov/pubmed/18459972

I have only had IVSM one time for five straight days. I hope to never have it again. I also did not do an oral taper. It seems that most neuros that are up to date with the research are not prescribing a taper anymore.

Thanks. I hope you never have to have it again also but it does work

I've had IVSM twice. Once without a taper (the first time) and once with a taper.

Having a taper made the crash from the steroids a heck of a lot easier to deal with. I got really sick the first time I had IVSM when the crash hit. (barfing sick)

I was still really tired and crashing a bit with the taper, but it was easier to deal with. Didnt get sick those first few days after I finished the IVSM. The second time I had IVSM, I pretty much begged for the taper.

Thanks Erin, that's how I feel. I am crashed

I never tapered it. 3 days, 1g a day was it.

Here is a good study that is ON-topic.

jackD


Eur J Neurol. 2008 Jul;15(7):677-80. Epub 2008 May 6.

Oral prednisone taper following intravenous steroids fails to improve disability or recovery from relapses in multiple sclerosis.

Perumal JS, Caon C, Hreha S, Zabad R, Tselis A, Lisak R, Khan O.
SourceDepartment of Neurology, Multiple Sclerosis Clinical Research Center, Wayne State University School of Medicine, Detroit & The Detroit Medical Center, Detroit, MI 48201, USA.

Abstract
BACKGROUND: A short course of intravenous methylprednisolone (IVMP) followed by oral prednisone taper (OPT) is often used for the treatment of relapses in multiple sclerosis (MS). We examined the effect of IVMP plus OPT compared with IVMP only on neurologic disability 1 year after treatment of a relapse in patients with relapsing-remitting multiple sclerosis.

METHODS: Two hundred eighty-five consecutive relapses were analyzed in a retrospective fashion. One hundred fifty-two patients with a total of 171 relapses received IVMP plus an OPT at the time of relapse whilst 112 patients who experienced 114 relapses received IVMP without OPT.

RESULTS: There was no difference between the two groups in the baseline characteristics as well as the mean or categorical EDSS at baseline, at the time of relapse confirmation, and at months 3, 6 and 12 after relapse confirmation.

CONCLUSION: Our observations suggest that OPT following treatment with IVMP for an MS relapse does not lead to improved neurologic outcome after 12 months compared with treatment with IVMP only.

Moreover, our findings raise concerns regarding the common practice of using OPT following IVMP.

Further studies are indicated to validate our findings and minimize exposure to systemic corticosteroids, well known for systemic toxicity.

PMID: 18459972 [PubMed

I would like to add this additional information about steroid treatment for optic neuritis because it is very important.

Doing without the oral prednisone taper is desirable.

jackD


Semin Ophthalmol. 2002 Mar;17(1):4-10.

Treatment of acute demyelinating optic neuritis.

Balcer LJ, Galetta SL.
SourceDivision of Neuro-Ophthalmology, Department of Neurology, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.

Abstract
Patients with typical acute monosymptomatic demyelinating optic neuritis should receive gadolinium-enhanced magnetic resonance imaging (MRI) of the brain and orbits to determine if they are at high risk for the subsequent development of clinically definite multiple sclerosis (CDMS). The presence of >or=2 white matter lesions (>or=3 mm in diameter, at least 1 lesion periventricular or ovoid) indicates high risk for CDMS; the following treatment should be considered for such patients: 1. Intravenous methylprednisolone sodium succinate (1 gram IV/day for 3 days) followed by oral prednisone (1 mg/kg/day for 11 days) with 4-day taper (20 mg on day 1, 10 mg on days 2 and 4); 2. Interferon beta 1-a (Avonex 30microg intramuscularly [IM] weekly, or Rebif 22 microg subcutaneously [SQ] weekly). These two drugs have been shown to reduce the short-term risk of CDMS in high risk monosymptomatic patients. In monosymptomatic patients with <2 white matter lesions, and in patients for whom CDMS has been established, IV methylprednisolone treatment followed by oral prednisone should be considered on an individual basis. Treatment in these patients may hasten visual recovery, but does not affect long-term visual outcome.

Oral prednisone alone, without prior treatment with IV methylprednisolone, may increase the risk for recurrent optic neuritis and should be avoided.

PMID: 15513449 [PubMed - indexed for MEDLINE]