Cortisone is a hormone naturally produced in the human body. It is made in the adrenal glands and causes, for example, the suppression of auto-immune reactions. If cortisone is taken for a long time, side effects such as osteoporosis, weight gain or skin changes can occur. These side effects are not expected during a short treatment course.
There are no set rules for the treatment of migraine with cortisone. The dose depends on general experience and the specific principles for the use of cortisone. Own experience is used as a basis for the treatment of migraines. The general rule is: cortisone is no routine medication, which is why no standards or general guidelines exist.
We only use cortisone in special situations such as a status migraenosus, if the pain does not subside after 3 days. For acute treatment prednisolone can be used in these cases. The dose is 100 to 250 mg, or more in difficult and complex situations.
The treatment with prednisolone usually has to be accompanied by other measures such as the treatment of nausea and vomiting, loss of electrolytes and water, stabilization of blood sugar levels, sedation and so on. These are always exceptional circumstances. The treatment cannot possibly follow set rules or intervals. It is best if it can be avoided. However, if needed then as infrequent as possible, once a quarter at the most. Prophylaxis is always a priority so that these escalations do not happen.