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.
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)
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
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
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,
about the immune system
So we're trying to decrease
that activity in a variety
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.
of our other medications
actually may kill or eliminate
certain types of cells.
So there's a wide spectrum,
and we have almost 20
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
is to stick with whatever plan
you and your healthcare team
Once we lose function, we cannot
So sticking to your treatment
regimen will let us know if it's
working or if it's not working.
You and your doctor will figure out which medicine is right for you.
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)
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.
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.
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.