When you have multiple sclerosis [MS], the long list of treatment options may seem overwhelming. How will you find what works for you? What if your symptoms change?
While there’s no cure for MS, there’s plenty of reason for hope. Treatments available today address many aspects of the disease. In fact, your physician has four main goals when treating your MS:
- Modify the course of the disease.
- Treat flare-ups.
- Control symptoms.
- Improve physical function.
When treatments target each of these goals, they can greatly improve your well-being and overall quality of life. Here’s a closer look at how different treatments achieve those goals.
Goal #1: Modify the Course of the Disease
Disease-modifying agents are medications that reduce disease activity and slow the progression of MS. They’re most often used for relapsing forms of MS, which are characterized by a flare-up of symptoms followed by periods of remission. These medications reduce the frequency and severity of those flare-ups.
Each drug works a little differently, so together with your doctor you can decide which is best for you, based on your disease characteristics and health history. There are currently 14 FDA-approved disease-modifying medications for MS. They are:
- Aubagio [teriflunomide], a daily pill
- Avonex [interferon beta-1a], a weekly injection
- Betaseron [interferon], an injection taken every other day
- Copaxone [glatiramer], a daily injection
- Extavia [interferon beta-1b], an injection taken every other day
- Glatopa [glatiramer], a subcutaneous injection taken every other day
- Gilenya [fingolimod], a daily pill
- Lemtrada [alemtuzumab], a five-day daily infusion
- Novantrone [mitoxantrone], an IV infusion taken four times a year
- Ocrevus [ocrelizumab], an IV infusion taken once every six months following a pair of initial infusions taken two weeks apart
- Plegridy [interferon beta-1a], a biweekly injection
- Rebif [interferon beta-1a], an injection taken three times per week
- Tecfidera [dimethyl fumarate], a twice-daily pill
- Tysabri [natalizumab], an IV infusion taken every four weeks
- Zinbryta [natalizumab], an IV infusion taken once a month
Goal #2: Treat Flare-Ups
When you do have a flare-up of MS symptoms, corticosteroids are the most common treatment because of their anti-inflammatory properties. Not all flare-ups need medication. But if your symptoms significantly interfere with your ability to function in your daily life, your doctor may suggest a course of corticosteroids.
Treatment for a flare-up often involves a 3- to 5-day course of high-dose corticosteroids administered intravenously. You may be able to receive the IV medication as an outpatient, either at home or in your doctor’s office. Some people may need to be hospitalized for this treatment.
Goal #3: Control Symptoms
There are a wide range of symptoms that can occur with MS, and they vary from person to person. With time, the symptoms you experience can change, too. As a result, the medications used to manage MS symptoms depend on which ones you’re experiencing. Here’s a brief overview of some of the types of medications used to treat different symptoms.
- Ampyra [dalfampridine]—helps walking speed and leg strength
- Antivert [meclizine]—helps control nausea, vomiting, and dizziness
- Cymbalta [duloxetine]—for depression and pain
- Detrol [tolterodine], Minipress [prazosin], and Oxytrol [oxybutynin]—for bladder dysfunction
- Nydrazid [ixoniazid]—controls tremors
- Levitra [vardenafil]—for erectile dysfunction
Goal #4: Improve Physical Function
As part of your treatment, you may participate in several forms of rehabilitation to help improve how you function in different aspects of your life. Rehabilitation programs, such as physical and occupational therapy, may focus on activities you need to be able to do at home or at work such as showering, cooking, and walking up stairs. If you experience memory or other cognitive problems, cognitive rehabilitation can help. With MS, you may develop problems with speech and swallowing; there’s therapy for that, too.
Beyond Medical Treatments
You may find that certain types of complementary and alternative medicine [CAM] help with the physical and emotional changes you experience with MS. Some of these options include acupuncture, yoga, biofeedback, naturopathy, and others. Discuss CAM options with your doctor to find what may work best for you in conjunction with the other treatments you receive.
In addition, exercising regularly can improve your heart health and reduce symptoms such as fatigue, weakness, and bladder and bowel problems. Stretching may help relieve tightness so you can move around more easily. Eat healthy, balanced meals with plenty of fiber to help improve your bowel health and keep you in the best condition to face any challenges MS may bring.