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Multiple Sclerosis: MS-Related Thinking Problems

WebMD Medical Reference

Reviewed By Louise Chang, MD

About half of people with MS will experience some problems with cognitive function. For most, this means slowed thinking, decreased concentration, or decreased memory. In only about 5% to 10% of MS patients is this so severe that it significantly impairs their ability to carry out daily living tasks.

Most of the time, difficulties with cognition occur later in the course of the disease; however, there are times where it occurs much earlier, and occasionally it's present with the onset of MS.

How Do I Know if My Thinking Is Impaired?

The first signs of impaired thinking are often subtle and usually recognized only in retrospect and often by another family member or loved one. They include:

  • Difficulty finding the right words to say.
  • Trouble remembering tasks.

How Is Impaired Thinking Diagnosed?

If you are having cognitive difficulties, it's important that you discuss this with your doctor. First your doctor will make sure that there isn't something other than the MS that is causing the problem, such as normal aging, a medication or depression.

If screening yields few clues, your doctor may recommend that you consult with a specialist who can test you to determine the nature of your cognitive difficulties.

How Is Impaired Thinking Treated?

Based on your test results, an occupational therapist, speech pathologist, or neuropsychiatrist may recommend a variety of exercises and techniques to help you better cope with your thinking problem.

Rarely, thinking problems become so severe that the person needs constant care or can't live at home. If this becomes an issue for you or a loved one, discuss your options with your doctor.

Recent Research

During the last few years, there have been numerous studies looking at ways to stabilize or improve cognitive dysfunction. Some of these studies are looking at whether the MS disease-modifying drugs could slow the progression of changes in cognition. 

Studies have also looked at other treatments that may temporarily improve cognitive functioning. Medications used for Alzheimer's patients may have a role here, but further research is needed.

WebMD Medical Reference

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Reviewed by Louise Chang, MD on October 21, 2011

© 2011 WebMD, LLC. All rights reserved.

Learn About Relapsing Multiple Sclerosis (MS) Treatment with GILENYA

Ask your doctor about GILENYA

Learn About Relapsing Multiple Sclerosis (MS) Treatment with GILENYA
Missi L. is a GILENYA guide and a paid Novartis spokesperson.
12/11 GYA-1113714

Indication

GILENYA is a prescription medicine used to treat relapsing forms of multiple sclerosis (MS) in adults. GILENYA can decrease the number of MS flare-ups (relapses). GILENYA does not cure MS, but it can help slow down the physical problems that MS causes.

Important Safety Information

GILENYA may cause serious side effects such as:

  • Slow heart rate, especially about 6 hours after your first dose. If your heart rate slows down, you might feel dizzy or tired, or be aware of a slow or irregular heartbeat. Your doctor will watch you for the first 6 hours after your first dose for any serious side effects. If you experience slow heart rate, it will usually return to normal within 1 month. Call your doctor if at any time you have dizziness, tiredness, or a slow or irregular heartbeat. If you stop taking GILENYA for 2 weeks or more, you will need to repeat this observation.
  • GILENYA may cause serious side effects such as increased risk of serious infections. GILENYA lowers the number of white blood cells (lymphocytes) in your blood. This will usually go back to normal within 2 months of stopping GILENYA. Your doctor may do a blood test before you start GILENYA. Increased risk of infection was seen with doses higher than the approved dose (0.5 mg). Two patients died who took higher-dose GILENYA (1.25 mg) combined with high-dose steroids. Call your doctor right away if you have fever, tiredness, body aches, chills, nausea, or vomiting.
  • Macular edema, a vision problem, can cause some of the same vision symptoms as an MS attack (optic neuritis), or no symptoms. Macular edema usually starts in the first 3 to 4 months after starting GILENYA. Your doctor should test your vision before you start GILENYA; 3 to 4 months after you start GILENYA; and any time you notice vision changes. Vision problems may continue after macular edema has gone away. Your risk of macular edema may be higher if you have diabetes or have had an inflammation of your eye (uveitis). Call your doctor right away if you have blurriness, shadows, or a blind spot in the center of your vision; sensitivity to light; or unusually colored vision.
  • Breathing problems. Some patients have shortness of breath. Call your doctor right away if you have trouble breathing.
  • Liver problems. Your doctor should do blood tests to check your liver before you start GILENYA. Call your doctor right away if you have nausea, vomiting, stomach pain, loss of appetite, tiredness, dark urine, or if your skin or the whites of your eyes turn yellow.
  • Increases in blood pressure (BP). BP should be monitored during treatment.

GILENYA may harm your unborn baby. Talk to your doctor if you are pregnant or planning to become pregnant. Women who can become pregnant should use effective birth control while on GILENYA, and for at least 2 months after stopping. If you become pregnant while taking GILENYA, or within 2 months after stopping, tell your doctor right away. Women who take GILENYA should not breast-feed, as it is not known if GILENYA passes into breast milk. A pregnancy registry is available for women who become pregnant during GILENYA treatment. Call 1-877-598-7237 for more information.

Tell your doctor about all your medical conditions, including if you had or now have an irregular or abnormal heartbeat; a heart rate less than 55 beats a minute; heart problems; a history of fainting; a fever or infection, or if you are unable to fight infections; eye problems; diabetes; breathing or liver problems; or high blood pressure. Also tell your doctor if you have chicken pox or have received the vaccine for chicken pox. Your doctor may do a test for the chicken pox virus, and you may need to get the vaccine for chicken pox and wait 1 month before starting GILENYA.

Tell your doctor about all the medicines you take, including medicines for heart problems or high blood pressure; medicines that could increase your chance of infections, such as medicines to treat cancer or control your immune system; or ketoconazole (an antifungal) by mouth. If taken with GILENYA, serious side effects may occur. You should not get certain vaccines while taking GILENYA, and for at least 2 months after stopping.

The most common side effects with GILENYA were headache, flu, diarrhea, back pain, abnormal liver tests, and cough.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see Full Prescribing Information, including Patient Medication Guide.

Important Safety Information | Prescribing Information | Medication Guide
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