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MS: Common Treatments for MS Symptoms

Reviewed by Michael W. Smith, MD on November 10, 2020

Multiple sclerosis (MS) symptoms can affect different parts of your body and brain. No two people have the same problems, so your doctors will develop a treatment plan just for you, whether the disease affects your mind, body, emotions, or any combination of the three.

Medications

Many people with MS take medicines to change the course of the disease. Some drugs slow the progress of MS in the brain and spinal cord. They can limit the number of relapses you have and slow the progression of any problems.

You’d get some in a shot, such as:

  • Glatiramer acetate (Copaxone)
  • Interferon beta-1a (Avonex, Rebif)
  • Interferon beta-1b (Betaseron, Extavia)
  • Ofatumumab (Kesimpta)
  • Peginterferon beta-1a (Plegridy)

Others come in pills:

  • Cladribine (Mavenclad)
  • Dimethyl fumarate (Tecfidera)
  • Diroximel fumarate (Vumerity)
  • Fingolimod (Gilenya)
  • Ozanimod (Zeposia)
  • Monomethyl fumarate (Bafiertam)
  • Siponimod (Mayzent)
  • Teriflunomide (Aubagio)

Still others you get through an IV infusion, such as:

  • Alemtuzumab (Lemtrada)
  • Mitoxantrone (Novantrone)
  • Natalizumab (Tysabri)
  • Ocrelizumab (Ocrevus)
How MS Treatment Works Inside Your BodyDisease-modifying therapies for multiple sclerosis try to change your immune system to fight inflammation and damage. See how the meds work on your cells.103

[MUSIC PLAYING]


MITZI JOI WILLIAMS:

Disease-modifying therapies are

ones that try to actually affect

the underlying immune process.

So with an autoimmune disease

your immune system

is overactive.

It's doing too much.

It's doing the things that it's

supposed to do, but it's doing

something extra that it

shouldn't be doing.

And so disease modification

means we're really trying

to affect

that underlying process to keep

more damage from happening.



So for some of the medications

we actually modulate or modify

the immune system,

meaning we try to change

the type of cells

so that there are more

anti-inflammatory or anti-attack

cells and less

of the inflammatory or cells

that can cause damage.

There are other medicines that

may do things like hide some

of the immune cells.

Because when we talk about MS,

we're talking

about the immune system

being overactive.

So we're trying to decrease

that activity in a variety

of ways.



So some of the medications

may hide the immune cells

so that there are less of them

available to attack the brain

and the spine

and cause those lesions.

And some

of our other medications

actually may kill or eliminate

certain types of cells.

So there's a wide spectrum,

and we have almost 20

disease-modifying therapies

for multiple sclerosis.

So we've come a very long way.



One of the most important things

I think that patients

and their family members

and care partners

need to recognize about MS

treatment

is to stick with whatever plan

you and your healthcare team

decide on.

Once we lose function, we cannot

regain it.

So sticking to your treatment

regimen will let us know if it's

working or if it's not working.

Mitzi Joi Williams, MD, clinical neurologist./delivery/aws/68/ac/68ac761a-e97c-3437-91c8-05a65006891d/091e9c5e81e73da8_expert-feature-how-ms-treatments-work_,4500k,2500k,1000k,750k,400k,.mp403/12/2020 12:00:0018001200photo illustration of human body nervous system/webmd/consumer_assets/site_images/article_thumbnails/video/expert_feature_how_ms_treatments_work_video/1800x1200_expert_feature_how_ms_treatments_work_video.jpg091e9c5e81e73da8

You and your doctor will figure out which medicine is right for you.

Continued

If you have a severe relapse, your doctor may prescribe corticosteroids. You might also hear them called steroids. They’re strong meds that can shorten your relapse. You could get a high-dose medication through an IV, like methylprednisolone (Solu-Medrol), or a high dose in pill form, such as prednisone (Deltasone). Or you might try repository corticotropin (H.P. Acthar). It can help your body make more steroid hormones.

Other drugs can treat symptoms that only affect some people with MS. Your doctor will know whether a medication is right for you based on your symptoms. For example:

If you have vertigo or dizziness because of your MS, your doctor may prescribe meclizine (Antivert).

If MS causes you pain, your doctor may give you medicines like:

  • Amitriptyline (Elavil)
  • Carbamazepine (Tegretol)
  • Clonazepam (Klonopin)
  • Duloxetine (Cymbalta)
  • Gabapentin (Neurontin)
  • Nortriptyline (Aventyl, Pamelor)
  • Phenytoin (Dilantin)
  • Pregabalin (Lyrica)

If you have trouble walking, the doctor will probably prescribe dalfampridine (Ampyra).

If you have spastic muscles, which can cause pain, muscle tightness, or walking problems, the doctor might try one of these:

  • Baclofen (Gablofen, Lioresal)
  • Clonazepam (Klonopin)
  • Dantrolene (Dantrium)
  • Diazepam (Valium)
  • Onabotulinum toxin A (Botox)
  • Tizanidine (Zanaflex)

Continued

For tremors, clonazepam or isoniazid (Laniazid, Nydrazid) can help.

To help with the fatigue MS can bring, the doctor could give you amantadine, fluoxetine (Prozac), or modafinil (Provigil).

If you get depressed, the doctor can prescribe one of several antidepressants. If you sometimes can’t control the urge to laugh or cry, dextromethorphan hydrobromide (Nuedexta) could help.

Other medications treat sexual problems or issues with bladder or bowel control. Ask your doctor which ones are right for you.

Therapy

Your doctor will probably suggest one of several types of therapy that can help you keep your independence.

If you need help with balance, muscle strength, or your ability to walk, your doctor may suggest physical therapy. The therapist might create an exercise program for you, or teach you how to use tools to help you move better, like canes, scooters, crutches, or wheelchairs.

If you need help to get dressed, do things around the house, or complete tasks at work, the doctor will probably send you to occupational therapy (OT). You’ll learn how to conserve energy and find tools that can make everyday tasks easier.

Continued

OT may also help if you need treatment for problems with learning, thinking, and memory.

If you have trouble with your speech or it’s tough to swallow liquids or food, it might help to meet with a speech-language pathologist.

Other treatments include:

Emotional support. If you feel depressed or have other mood changes, it could be time to see a mental health professional. It can also help to talk about your feelings with friends and family.

Exercise. Regular activity can help you feel less tired, improve your mood, and help with bladder and bowel function. If you stretch often, it may ease stiffness and help you move better.

Stress management. Stress affects people in different ways. Doctors aren’t sure if it makes some MS symptoms worse, but if you ease the stress in your life, it could ease your symptoms. It’s good for your overall health, too.

Acupuncture. This traditional Chinese technique involves a specialist who puts thin needles into points on your body to help the flow of energy. Some doctors suggest acupuncture for people with MS. See if your doctor thinks it’s right for you.

WebMD Medical Reference

Sources

SOURCES:

National Institute of Neurological Disorders and Stroke: “Multiple sclerosis: Hope through research,” “Multiple sclerosis information page.” 

National Multiple Sclerosis Society: “Medications,” “H.P. Acthar,” “Ampyra,” “Nuedexta,” Acupuncture,” “Rehabilitation,” “Comprehensive care,” “Complementary and Alternative Medicine.”

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