How do the side effects compare

The side effects of ACTH are generally similar to those of steroids taken orally or by IV administration, but are less severe. All of the side effects seen with steroids, including psychosis but excluding muscle

Manic psychosis a state of elevated mood and psychosis.

weakness and bone injury, may occur with ACTH. Certain hormones induced by ACTH and produced by the adrenal glands, the "keto-steroids" (like testosterone), have an anabolic (protein building) effect. In other words, as in athletes, anabolic steroids that are induced by ACTH treatment are capable of making muscles somewhat stronger. In contrast, the net effect of steroids is catabolic (protein destroying).

Karen's comment:

When I was first diagnosed with MS, my doctor at the time prescribed steroids, specifically oral prednisone, intravenous steroid methylprednisolone, and then more oral prednisone. As a result, I was simultaneously dealing with the diagnosis, my body going through things it had never done before (such as vision loss, MRI, and spinal tap), emotionally managing the logistics of a nurse for the IV steroids, processing the mounds of insurance forms, and coping with the side effects of the steroids.

Fortunately, I have low blood pressure, am not overweight, and manage my diet well, so I missed many of the side effects—however, not all. I got the telltale "Cabbage Patch Doll"face such that my eyeglasses would barely squeeze on. For several months, I was "hyper" and unable to sleep from midnight to 4 AM. I would alphabetically arrange our 1,000 books. Other odd things happened, such as when the hair on my arms fell out.

Coming off the steroids was hard as well. My body was addicted. One day I yelled at my husband for eating a potato chip too loudly when he was three rooms away. On another day, I felt a loss of adrenaline and ate an entire box of Dots candy I grabbed from the shelf of our grocery store. All told, from first dose to last weaning pill, I had 6

months of steroids—2 months of intended benefit and 4 months for withdrawal. Almost 10 years later I still have residual effects from that one event with steroids: I have some change in my body shape that is referred to as trunk effect, osteoporosis, and pre-cataract fibers in my eyes.

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