Clinical considerations in the use of corticosteroids.

Factors concerned with the institution of prolonged, nonspecific corticoid therapy are discussed in detail because of the seriousness of the complications that may occur and the magnitude of the clinical problem. Particular attention has been paid to the psychologic effects of ACTH and corticosteroid therapy with reference to the manner in which "habituation" to these agents may complicate the attempt to reduce or discontinue therapy at a later date. A plea is made to reassess regularly the possibility of effecting a reduction in dosage in all patients being maintained for prolonged periods on corticosteroids. Finally, a program is suggested that is based on physiologic concepts that may be employed when complete withdrawal of corticosteroid therapy is contemplated.