—Controversy concerning the intraspinal use of methylprednisolone acetate (Depo-Medrol, Upjohn Co, Kalamazoo, Mich) began in 1970, naturally leading to a number of editors' invitations (as here) for me to reply to adverse opinions.The manufacturer issued its first warning concerning epidural use in the United States in October 1989 and in Australia in November 1990. Because the drug has a 36-month shelf life, Strong et al may not have yet seen the new package-insert pamphlet, and the Upjohn Company plans no general "Dear Doctor" letter. Six months after the warning against epidural use in the United States was first printed, I was notified that about 150 patients in Western Australia claimed complications from epidural steroid therapy.1 Why such a large number of patients in one Australian state spontaneously reported their symptoms without media induction or medical publications is unknown. Contrary to Strong et al, I believe
Nelson DA. Epidural Steroids Are Safe and Effective When Given Appropriately-Reply. Arch Neurol. 1991;48(10):1012–1013. doi:10.1001/archneur.1991.00530220028014
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