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Treatment Options
Multiple Sclerosis (MS)
How is it treated?
The treatment of MS focuses mainly on decreasing the rate and severity of relapse, reducing the number of MS lesions, delaying the progression of the disease, and providing symptomatic relief for the patient. Several different drugs have been developed to treat the symptoms of MS. However, in patients with the relapsing-remitting type, it is often difficult to determine if symptomatic improvements are the result of drug therapy or if it is just the natural course of the disease. The following summary of the most recent treatment guidelines outlines medications for each type of MS, describes the ways they work, and discusses their benefits for MS patients.
Relapsing/Remitting Multiple
Sclerosis Treatment
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Drug Therapy
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How It Works
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Benefits
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Interferon beta-1b (Betaseron)
Injected under the skin every other day.
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Interferons are substances produced by the body to regulate the immune system.
In this case, diminishing the activity of the specific white blood cells causing disease.
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- Decreases rate of relapse
- Decreases
development of new lesions
- Delays progression of disability
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Interferon beta-1a (Avonex)
Injected into the muscle once a week
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Interferons are substances produced by the body to regulate the immune system.
In this case, diminishing the activity of the specific white blood cells causing disease
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- Lower incidence of disease resistance associated with this dosing regimen
* However, may not be quite as effective at reducing relapse rates and development of new lesions when compared to Rebif |
High-dose/frequency Interferon beta-1a (Rebif)
Injected under the skin three times a week
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Interferons are substances produced by the body to regulate the immune system.
In this case, diminishing the activity of the specific white blood cells causing disease
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- Decreases rate of relapse
- Decreases development of new lesions
- Delays progression of disability
* There is currently no data comparing the effectiveness of Rebif with Betaseron.
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Glatiramer (Copaxone)
Injected under the skin daily
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Exactly how glatiramer works is unknown, but it is believed to modify the immune process that causes MS.
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- Decreases rate of relapse
- Moderately decreases development of new lesions
- May delay progression of disability
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Secondary Progressive Multiple
Sclerosis Treatment
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Drug Therapy
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How It Works
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Benefits
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| Interferon
beta (Betaseron, Avonex, Rebif)
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Interferons are substances produced by the body to regulate the immune system.
In this case, diminishing the activity of the disease causing white blood cells.
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- Decreases rate of relapse
- Delays increase in the size of lesions
- May delay progression of disability
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| Mitoxantrone
(Novantrone)
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Mitoxantrone inhibits specific cells of the body's defense system that destroy myelin
in the central nervous system.
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- Decreases rate of relapse
- May delay progression of disability
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Primary Progressive and Progressive/Relapsing Multiple Sclerosis Treatment
No treatment is currently approved, however, those disease modifying therapies that reduce progression of MS may be beneficial.
Short-term treatment (3-5 days) with corticosteroids (like prednisone, methylprednisolone, dexamethasone, others) can aid during periods of acute relapse. The proposed mechanism by which corticosteroids work and the possible benefits they can provide are listed in the table below.
For Acute Relapse of Multiple Sclerosis
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Drug Therapy
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How It Works
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Benefits
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| Corticosteroids
(methylprednisolone, prednisone, dexamethasone)
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Corticosteroids
work by decreasing the intensity of the body defense system's reaction to
the myelin in the central nervous system.
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- Hastens recovery from acute attacks
- Prevents damage to the blood-brain barrier.
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Not only do healthcare practitioners treat the disease itself, but also the accompanying symptoms. The chart below details drugs used to help relieve common symptoms associated with MS.
For Relief of Symptoms,
Regardless of MS Type
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Drug Class
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How It Works
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Symptom Relieved
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| Muscle Relaxants (Baclofen, Dantrolene, Tizanidine, Cyclobenzaprine, Clonazepam, Diazepam)
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Muscle relaxants (also used for a number of other conditions), help to relieve
spasms and stiffness for people with MS.
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- Walking difficulties
- Muscle spasms
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| Anticholinergics (Propantheline, Tolterodine Dicyclomine)
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Anticholinergic drugs reduce the frequency and intensity of spasms of the bladder and bowel.
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| Urinary Tract Antispasmodics (Oxybutynin)
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By relaxing muscles in the bladder, antispasmodics increase the bladder's ability to hold urine. It also reduces bladder spasms, limits the urge to pass urine, and lessens the frequency of involuntary urination.
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Tricyclic Antidepressants (Amitriptyline, Imipramine)
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Tricyclic antidepressants rebalance chemicals in the central nervous system, which helps to relieve MS-associated sensory symptoms. Some of their side effects (dry mouth and urine retention, for example) make them effective for treating bowel and bladder spasm.
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- Bowel spasms
- Bladder difficulties
- Sensory symptoms (like numbness, tingling sensations)
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| Antidiuretic Hormone
(Desmopressin, DDAVP)
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Antidiuretic hormone decreases urine flow through the kidneys.
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| Anticonvulsants (Carbamazepine, Phenytoin, Acetazolamide, Lamotrigine)
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Usually used to prevent or relieve seizures, anticonvulsants rebalance chemical
levels in the brain, relieving sensory symptoms caused by MS.
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- Sensory symptoms (like numbness, tingling sensations)
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Central Nervous System Stimulants (Pemoline)
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Through an unknown process, pemoline stimulates the central nervous system,
helping to relieve the tiredness that frequently accompanies MS.
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Selective Serotonin Reuptake Inhibitors (SSRIs)
(Citalopram, Fluoxetine, Paroxetine,Sertraline)
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The ability of SSRIs to alter the levels of certain chemicals in the brain creates a stimulation effect.
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Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
(Ibuprofen, Naproxen, Ketoprofen)
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Good for relieving minor aches and pains, NSAIDs can also reduce fever in
patients taking Interferons.
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- Flu-like symptoms associated with Interferons
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Phosphodiesterase-5 Inhibitors
(Sildenafil, Tadalafil, Vardenafil)
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These drugs alter the body's response to sexual stimulation in order to correct sexual dysfunction.
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* Sildenafil is currently being studied in females with MS and sexual dysfunction |
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Last Updated: August 2007
This content was created by members of the DrugDigest team of experts and is solely under DrugDigest's editorial control.
Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.
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How is it treated?
