Multiple Sclerosis (MS) - Medications
multiple sclerosis (MS) may be used:
- During a
relapse, to make the attack shorter and less
- Over a long period of time, to alter the natural course of
the disease (disease-modifying therapy).
- To control specific
symptoms as they occur.
Controlling a relapse
Medicines can shorten a
sudden relapse and help you recover more quickly. Temporary treatment with
corticosteroids is the most common treatment used to
control a relapse. These medicines have not been shown
to affect the long-term course of the disease or to prevent disability.
Altering the course of MS using disease-modifying treatment
Strong evidence suggests that MS is caused by the
immune system causing
inflammation and attacking the myelin, which is the coating
surrounding the nerve and nerve fibers. Medicines that change the activity of
the immune system can reduce the number and severity of attacks that damage the
Interferon beta (such as Betaseron), glatiramer (Copaxone), mitoxantrone (Novantrone),
natalizumab (Tysabri), and fingolimod (Gilenya) are the only medicines that have been approved for this
purpose. For people with
relapsing-remitting MS, these medicines can reduce
the number and severity of relapses and can result in fewer brain lesions. They
may also delay disability in some people. Some of these medicines may delay
disease progression in some people who have
secondary progressive MS.
there is no effective disease-modifying treatment for
primary progressive MS.
Some people have
only one episode of a neurological symptom such as
optic neuritis. Yet
MRI tests suggest these people have MS. This is known
as a clinically isolated syndrome. Many of these people go on to develop MS
over time. In some cases, doctors will prescribe medicine (either interferon
beta or glatiramer) for people who have had a clinically isolated syndrome.
These medicines, when taken early or even before you have been diagnosed with
MS, may keep the disease from getting worse or extend your time without
Treating specific symptoms can
be effective, even if it does not stop the progression of the disease. Symptoms
that can often be controlled or relieved with medicine include:
- Fatigue. Medicines to reduce fatigue or help you
sleep better may include amantadine (Symmetrel) or fluoxetine
- Muscle stiffness (spasticity) and tremors. Medicines
that may reduce muscle spasms or stiffness include baclofen (Lioresal),
tizanidine (Zanaflex), dantrolene (Dantrium), gabapentin (Neurontin), diazepam
(Valium), or clonazepam (Klonopin). Sometimes a combination of these
medicines works best to reduce your muscle symptoms.
- Urinary problems and constipation. Medicines used to reduce frequent urination may include
propantheline, oxybutynin (Ditropan), or tolterodine (Detrol).
Medicines sometimes used to relieve constipation include bulk agents such as
psyllium (Metamucil) or daily use of laxatives.
- Pain and abnormal sensations. Depending on the severity of the pain, both
prescription and nonprescription medicines may be tried. Over-the-counter
medicines may include acetaminophen, ibuprofen, or naproxen sodium.
Prescription medicines commonly used to reduce pain associated with MS
include baclofen (Lioresal), carbamazepine (Tegretol), and gabapentin
- Depression. Antidepressant medicines may be used to
reduce depression that often occurs as a result of having MS. Antidepressants
often tried include tricyclic antidepressants (such as amitriptyline,
desipramine (Norpramin), or imipramine (Tofranil)) or selective serotonin
reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) or sertraline (Zoloft).
- Sexual difficulties. Medicines used
to relieve sexual difficulties that can be associated with MS include
sildenafil (Viagra) for both men and women. Yohimbine and clomipramine may also
be given to improve
- Walking problems. Dalfampridine (Ampyra) is a medicine that can be used to help with walking problems caused by MS.