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Multiple Sclerosis (MS) - Treatment Overview
SYMPTOMS & TREATMENTS
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Treatment can make living with multiple sclerosis (MS) easier. Your type of treatment will depend on the severity of your symptoms and whether your disease is active or in remission.
Initial treatment
In an attempt to slow down the progression of multiple sclerosis (MS), treatment with medicine is usually recommended when MS has been diagnosed. Findings from clinical studies show that people treated soon after being diagnosed with MS may have better results than those who delay treatment. Permanent damage to the nervous system may occur in the initial stages of the disease. Early treatment may help prevent or delay some of this damage.
Medicines used to treat MS are called disease-modifying therapies, and they include:
- Interferon beta (such as Betaseron).
- Glatiramer (Copaxone).
- Mitoxantrone (Novantrone).
- Natalizumab (Tysabri).
- Fingolimod (Gilenya).
These medicines suppress or alter the activity of the immune system.
Although these medicines do not cure MS, they may reduce the overall number, frequency, and severity of relapses in some people who have the relapsing-remitting MS. They may also reduce or delay disability with this type of MS. Some of these medicines are also used to slow disease progression in people who have secondary progressive MS.
If you decide not to try disease-modifying therapy at this time, you can work with your doctor to regularly evaluate whether the disease is progressing. For more information on this decision, see:
Physical therapy, occupational therapy, and nonmedical treatment done at home can help you manage symptoms and adjust to living and working situations. For more information, see:
Ongoing treatment
If you have been diagnosed with multiple sclerosis (MS), you may need to take medicine indefinitely.
The medicines used most commonly to treat MS are:
Other medicines your doctor may have you try include:
- Fingolimod (Gilenya). Gilenya is the only medicine for MS that you can take by mouth (oral).
- Natalizumab (Tysabri). Tysabri was taken off the market in 2005 after studies showed the medicine could possibly be linked to a serious infection called progressive multifocal leukoencephalopathy (PML). Soon after, the U.S. Food and Drug Administration (FDA) re-approved Tysabri for use in people with relapsing forms of MS. If you are taking Tysabri, you will be watched closely for signs of any serious side effects.
- Intravenous immune globulin (IVIG). Intravenous means the medicine is given in a vein. Immune globulin is a protein in human blood and tissue fluids. These proteins are similar to antibodies, which help the body's immune system recognize and destroy foreign substances, such as bacteria and viruses.
These medicines suppress or alter the activity of the immune system. Evidence suggests that MS is an autoimmune disease, a disease in which the immune system attacks normal body tissue. In this case, the myelin coating surrounding nerve fibers is attacked by the immune system.
You also can take other medicine during attacks or relapses. Corticosteroids are commonly used to shorten relapse time and may limit its severity. But corticosteroids do not prevent permanent disability from MS and have not been shown to delay or prevent the progression of the disease.
If you are not taking disease-modifying therapy at this time, you can continue to work with your doctor to regularly evaluate the disease's progress. If new lesions develop or existing lesions grow, you may want to reconsider your decision and begin treatment. For more information, see:
You and your doctor will set up a schedule of periodic appointments to monitor and treat your symptoms and follow the progress of your MS. Monitoring your condition helps your doctor find out whether you may need to try a different treatment.
Physical therapy, occupational therapy, and nonmedical treatment done at home can help you manage symptoms and adjust to living and working situations. For more information, see:
Treatment if the condition gets worse
Medicines should relieve symptoms that cause discomfort and disability from multiple sclerosis (MS). Symptoms such as spasticity (stiff, tight muscles), pain, fatigue, tremor, depression, sexual difficulties, and bladder problems often respond well to medicines.
Physical therapy, occupational therapy, and nonmedical treatment done at home may also help you manage symptoms and adjust to living and working situations. For more information, see:
What To Think About
Findings from clinical trials indicate that people treated soon after being diagnosed with MS may have better results than those who delay treatment.
The National Multiple Sclerosis Society recommends that people with a definite diagnosis of MS and active, relapsing disease start treatment with interferon beta or glatiramer. This groups adds that treatment with medicine may also be considered after the first attack in some people who are at a high risk for MS.4
Still, taking the medicine has several significant drawbacks. The decision is a hard one for many people with MS. Some wait to see whether their symptoms get worse before they make a decision to start therapy. A small percentage of people diagnosed with MS may never have more than a few mild episodes and never develop any disability. But there is no way to know yet who will fall into this group.
End-of-life issues
In rare cases, multiple sclerosis (MS) is life-threatening. If your condition gets considerably worse, you may want to make a living will, which allows your wishes to be carried out if you are not able to make decisions for yourself. For more information, see the topic Care at the End of Life.
| By: | Healthwise Staff | Last Revised: November 10, 2010 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Adam Husney, MD - Family Medicine Colin Chalk, MD, CM, FRCPC - Neurology | |
© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
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