About MS treatment
While there’s no cure for multiple sclerosis (MS), there are many treatments available. These treatments mainly focus on slowing down the progression of the disease and managing symptoms.Different people can have different types of MS. And disease progression and symptoms range greatly from person to person. For both reasons, each person’s treatment plan will be different. Read on to learn about the types of MS treatments available.
Disease-modifying medications can reduce the frequency and severity of MS episodes, or relapses. They also can control the growth of lesions (damage to nerve fibers) and reduce symptoms.
There are currently several drugs approved by the U.S. Food and Drug Administration (FDA) for modifying MS. They come as injectables, infusions, and oral treatments.
These four medications are given as injections:
- interferon beta-1a (Avonex, Rebif)
- interferon beta-1b (Betaseron, Extavia)
- glatiramer acetate (Copaxone, generic versions)
- pegylated interferon beta-1a (Plegridy)
These four therapies must be given by infusion at a licensed clinic:
- alemtuzumab (Lemtrada)
- mitoxantrone (Novantrone)
- natalizumab (Tysabri)
- ocrelizumab (Ocrevus)
These three treatments you take by mouth as pills:
- teriflunomide (Aubagio)
- fingolimod (Gilenya)
- dimethyl fumarate (Tecfidera)
Ending a relapse as quickly as possible benefits both the body and the mind. That’s where relapse treatments come in.
Inflammation is a key feature of MS relapses. It can lead to many other symptoms of MS, such as:
Corticosteroids are often used to ease inflammation and reduce the severity of MS attacks.
Corticosteroids used to treat MS include methylprednisolone (intravenous) and prednisone (oral).
If corticosteroids don’t provide relief for relapses, or if intravenous treatments can’t be used, there are other treatments. These may include:
- ACTH (H.P. Acthar Gel): ACTH is an injection into your muscle or under your skin. It works by prompting the adrenal cortex gland to secrete the hormones cortisol, corticosterone, and aldosterone. These hormones reduce the level of inflammation in your body.
- Plasmapheresis: This process involves removing whole blood from your body and filtering it to remove antibodies that may be attacking your nervous system. The “cleansed” blood is then given back to you as a transfusion.
- Intravenous immunoglobulin (IVIG): This treatment is an injection that helps to boost your immune system. However, evidence of its benefits for MS relapses has been inconsistent in clinical studies.
Medications for physical symptoms
While the drugs listed above help treat MS, a range of medications are available to treat the different physical symptoms that MS can cause.
Drugs for pain and other muscle problems
Muscle relaxants are often prescribed for people with MS. That’s because relaxing muscles helps with common MS symptoms such as:
- muscle spasms
Relieving those symptoms can also help with depression, which can occur with MS.
Drugs for muscle stiffness include:
- baclofen (Lioresal)
- cyclobenzaprine (Flexeril)
- diazepam (Valium)
- tizanidine (Zanaflex)
Drugs for fatigue
Fatigue is a common symptom for people with MS. Drugs used to treat fatigue include modafinil (Provigil). They also include amantadine hydrochloride (Gocovri), which is used off-label for this purpose. Off-label use is when a drug that’s approved for one purpose is used for another.
Fluoxetine (Prozac) is also often prescribed since it helps combat both fatigue and depression.
Drugs for bladder and bowel problems
There are more than a dozen prescription medications for bladder problems (such as incontinence) related to MS. Talk to your doctor about which drugs might be best for you.
The most effective medications for constipation and bowel symptoms associated with MS seem to be over-the-counter stool softeners. If you have questions about these products, ask your pharmacist.