Although there is currently no cure for MS, there are a variety of medications used to treat the disease. These treatments fall into three main categories including drugs that modify the progression of the disease, drugs that treat MS flare-ups, and drugs that treat the various side effects of the disease. There are also a variety of alternative treatment therapies that can be used in conjunction with these MS medications to lessen symptoms and improve the quality of life of those living with the disease.
MS Medications: Disease-Modifying Drugs
There are many medications that can be used to manage, modify, and slow the progression of MS, known as disease-modifying drugs. For patients with relapsing-remitting MS, doctors often choose to begin with these treatments as they slow the disease while also keeping flare-ups at bay. These disease-modifying treatments work by targeting the immune system in order to keep it from attacking and damaging the myelin — the protective coating around the nerves.
Similarly, MS medication used to modify the progression of the disease is also an effective treatment option for patients with primary-progressive MS. However there is currently only one drug approved by the FDA for this type of therapy, which can slow down the progression of disability for those with primary-progressive MS.
Since a large portion of the immune response surrounding MS happens during the initial phases of the disease, aggressively treating it with these disease-modifying therapies can both decrease the rate of relapse and slow down new lesion formation. However, it is important to keep in mind that these types of drugs can have a wide range of serious side effects. For this reason, it is important for you and your doctor to consider your specific case to determine the best treatment option for you.
According to the National MS Society, the below medications are FDA-approved disease-modifying treatments that have been shown in clinical studies to reduce flare-ups, delay progression of the disease, and decrease new MS activity. These MS medications are all either injectable, oral, or infused.
Oral Disease-Modifying MS Medications:
There are three FDA-approved MS drugs that can be taken orally to treat the disease. These medications include Tecfidera (dimethyl fumarate), Gilenya (fingolimod), and Aubagio (teriflunomide).
Injectable Disease-Modifying MS Medications:
There are nine injectable therapies approved by the FDA for treatment of MS. These include
Zinbryta (daclizumab), Rebif (interferon beta-1a), Plegridy (peginterferon beta-1a), Glatopa (glatiramer acetate, which is the generic equivalent of a Copaxone 20mg dose), Glatiramer Acetate Injection (glatiramer acetate, which is the generic equivalent of the Copaxone 20 mg dose and 40 mg dose), Extavia (interferon beta-1b), Copaxone (glatiramer acetate), Betaseron (interferon beta-1b), Avonex (interferon beta-1a).
Infused Disease-Modifying MS Medications:
Additionally, there are four infused medications approved by the FDA for treatment of MS, which include Tysabri (natalizumab), Novantrone (mitoxantrone), Ocrevus (ocrelizumab), Lemtrada (alemtuzumab).
Ocrevus, also known as ocrelizumab, is also the only one of these disease-modifying therapies that is FDA-approved for use in the treatment of primary-progressive MS.
MS Medications: Relapse Treatments
Relapses also referred to in the medical community as flare-ups, exacerbations, or attacks, occur when individuals experience new symptoms or a worsening of existing symptoms. These flare-ups vary greatly between patients and can range in severity, with common symptoms including optic neuritis, fatigue, or balance problems. A relapse can last for as little as a few days or for months on end, and typically go away on their own without medical treatment.
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However, depending on the severity of these symptoms, there are several treatment options available for patients experiencing flare-ups.
High-Dose Steroids
The most common treatment used to treat MS relapses is steroids, which can be given intravenously or by mouth to reduce inflammation. Although steroid treatment will not cure the disease or modify the progression, it will treat the relapse symptoms and bring them to an end more quickly.
Plasma Exchange
In rare cases, patients do not respond to steroid treatment. In these situations, another treatment option that can be used to shorten a relapse is a plasma exchange. This is a procedure in which blood is taken and the plasma is removed from the blood cells. These cells are then blended with albumin, a protein solution, and put back into the patient.
MS Medications: Symptom Management
Since MS can cause a wide range of symptoms there is an assortment of drugs that can be used to treat the specific symptoms affecting patients. Below are some of the most common symptoms of MS and the medications that can be used to treat these conditions.
Depression
Antidepressants such as sertraline (Zoloft) and fluoxetine (Prozac) can be used to manage depression in patients with MS.
Stiffness/Muscle Spasms
To treat symptoms of spasticity, muscle relaxants including tizanidine (Zanaflex) or baclofen (Lioresal) as well as sedatives including clonazepam (Klonopin) or diazepam (Valium) are commonly used.
Fatigue
There are several medications that can be used to treat symptoms of fatigue in MS patients including armodafinil (Nuvigil), modafinil (Provigil), and Amantadine (Symmetrel).
In addition to these symptoms, some of the other common symptoms of MS that can be treated using medication include pain, itching, bladder problems, emotional changes, sexual problems, bowel dysfunction, dizziness, and vertigo.
MS Medications: Alternative Therapies
In addition to medications used to modify the course of MS, shorten and treat relapses, and treat symptoms of MS, alternative therapies can also be used alongside these treatments to help patients with MS feel their best. Some of the most common alternative therapies (also known as complementary therapies) used to manage symptoms of MS are detailed below.
Massage/Bodywork
Getting regular massages is an excellent way for individuals with MS to lessen symptoms of pain and stiffness. Massage therapy can also reduce stress and depression that often accompany the disease.
Acupuncture
Although there is no scientific evidence to back it up, many MS patients report that acupuncture helps reduce symptoms including muscle spasms, pain, and even bladder control issues.
Medical Marijuana
Similarly, many MS patients report relief of MS-related symptoms from ingesting or smoking medical marijuana. Although more research is still needed on the benefits and side effects of medical marijuana for MS patients, the American Academy of Neurology has recommended oral cannabis extract for the treatment of pain and muscle spasticity. However, they “do not recommend cannabis in any other form for other MS symptoms due to a lack of evidence.”
Exercise
Staying active with gentle exercises like tai chi and yoga can be helpful in decreasing stress and increasing relaxation and energy in MS patients. Forms of exercise like these can also improve balance and flexibility. If you are interested in learning about what exercises will work to help manage your symptoms, you should check with your doctor.
Evening Primrose Oil
Also known as linoleic acid, this supplement, which can also be found in safflower oil and sunflower seeds, may provide relief to some symptoms of MS.
Chiropractic Therapy
Although chiropractic therapy cannot alter the course of the disease, it can be helpful in relieving symptoms associated with MS, such as lower back pain.
Although there is not yet a cure for MS, there are many MS medications that can modify the progression of the disease, shorten relapses, and treat the symptoms caused by MS. There are also a variety of alternative therapies, that, when used in conjunction with medication, can relieve symptoms and improve your quality of life.
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