Managing Multiple Sclerosis: What Medications May Help?

Multiple sclerosis (MS) does not have a cure, but some treatments and medications can ease the symptoms, enhance recovery from relapses, modify its course, limit new disease activity, and slow the progression of the disease. Treatment depends on the exact symptoms the patient has.

Key takeaways:
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    MS can be treated by steroids, plasmapheresis, and other medications in oral and infused forms.
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    All the medications have significant side effects that should be discussed with your doctor.
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    It is important to treat the comorbidities that accompany MS as that can improve your quality of life.
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    A team of health professionals can also provide interventions to assist in the management of MS, ease its symptoms, reduce the number of relapses, and enhance recovery from relapses.

Selecting the right therapy depends on the duration and severity of Multiple sclerosis, the type of MS, the effectiveness of previous MS treatments, other health conditions, childbearing status, and cost. If you are pregnant or considering becoming pregnant, talk with your doctor before starting or continuing any of the medications used for MS.

The treatment of multiple sclerosis requires many disciplines. Occupational therapy focuses on adaptive self-care, home management training, energy-saving techniques, and home modification for safety and independence. Physical therapy works on stretching muscles, strengthening muscles, balance, and gait training. Speech and language pathologists address speech and swallowing problems.

Cognitive behavioral therapy focuses on managing fatigue and depression. Relationship counseling may help deal with sexual issues. Continence specialists and urologists help with bladder dysfunction. Eye care specialists can help with double vision and other vision problems. Thinking and memory may be addressed by a neuropsychologist.

Medications for multiple sclerosis treatment

A relapse can be treated with a 5-day course of steroids, at home or in the hospital. To avoid side effects (weight gain, insomnia, mood swings, and weak bones), it is not recommended to use steroids more than 3 times per year. If relapse symptoms do not respond to steroids, plasma exchange or plasmapheresis may be used. During this procedure, the liquid (plasma) portion of the blood is exchanged for a protein solution. The red blood cells are collected and combined with the protein solution and put back into your body.

Some other treatments/interventions for relapsing-remitting Multiple sclerosis include:

Oral

Gilenya - side effects include immediate slowed heart rate, headaches, high blood pressure, rare life-threatening infections, and blurred vision.

Tecfidera - side effects include nausea, diarrhea, and flushed skin.

Vumerity - fewer side effects than Tecfidera.

Aubagio - side effects include hair loss, liver damage, and potential birth defects when taken by men and women for up to 2 years after stopping treatment.

MavenClad - also good for secondary progressive MS. Side effects include tumors, upper respiratory tract infections, and headaches.

Siponimod - also good for secondary progressive MS. Side effects includes changes in heart rate, vision, and headaches.

Injectable

Avonex - side effects include depression, flu-like symptoms, seizures, liver damage, allergic reactions, and heart failure.

Rebif - side effects include depression, flu-like symptoms, abdominal pain, shortness of breath, thyroid dysfunction, and tachycardia.

Betaseron and Extavia (same medication; different brand name) - side effects include depression, flu-like symptoms, thyroid dysfunction, allergic reaction, and weight gain.

Copaxone - side effects include injection site reactions, shortness of breath, anxiety, fat atrophy at injection sites, and chest pain.

Infusion treatments

Ocrevus - side effects include infusion reactions such as rash and mouth pain, upper and lower respiratory tract infections, depression, and back.

Tysabri - side effects include headache, joint pain, depression, and nausea.

Campath/Lemtrada - side effects include rash, thyroid problems, feeling tired, and fever.

Novantrone - side effects include diarrhea/constipation, loss of appetite, and sores of the tongue and mouth. Due to the potential for cardiac toxicity, this medication requires monitoring of your heart function before and during treatment.

Other medications used to treat the complications of multiple sclerosis include:

Complication of MSMedications
Bladder dysfunctionBotox, Detrol, Ditropan, Flomax
InfectionsBactrim, Cipro, Levaquin, Macrodantin
Bowel dysfunctionColace, Dulcolax, Fleets Enema, Metamucil
DepressionCymbalta, Effexor, Paxil, Wellbutrim
Dizziness and VertigoAntivert
Emotional changesNuedexta
FatigueRitalin, Adderall, Amantadine
TremorsLaniazid, Klonopin
Gait problemsAmpyra
ItchingVistaril
PainCymbalta, Elavil, Neurontin, Tegretol
Sexual problemsCialis, Viagra, Levitra
SpasticityBaclofen, Botox, Valium
Visual problemsNeurontin

These drugs may cause issues in pregnancy. If you have MS and are pregnant or planning to become pregnant, speak to your doctors immediately.

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