Drugs for Managing MS and Its Symptoms
Disease-Modifying Immunotherapy
This first section for the treatment of multiple sclerosis (MS) provides information about disease-modifying immunotherapy, also referred to as disease-modifying therapy (DMT). This includes eight individual drug treatments approved by the Food and Drug Administration (FDA) to slow MS disease activity and progression.
Five of these eight individual medications are given via self-injection at one's home, varying from once daily to once weekly, depending on the drug selected. These five injectable medications include the interferons (Avonex®, Betaseron®, Extavia®, and Rebif®) and glatiramer acetate (Copaxone®). Natalizumab (Tysabri®) and mitoxantrone (Novantrone®) are given individually via intravenous injection (IV) at a medical facility. The most recently approved drug for the long-term treatment of MS is fingolimod (Gilenya®). This new drug is the first DMT for MS that is taken orally.
The majority of individuals with MS may benefit from taking one of these immunotherapy drugs. Research has shown that early treatment is the most effective strategy in minimizing damage to the nerves. Newly diagnosed individuals, as well as individuals diagnosed previously who are not on an immunotherapy, should speak with their physician to see if they may benefit from one of these treatments.
Please refer to Treatments for Multiple Sclerosis for a full description of the approved long-term treatments for MS and a chart of these medications, summarizing how these medications are administered, as well as potential side effects and other notes.
Please refer to MSAA’s listing of patient-assistance programs for information on financial assistance for these disease-modifying therapies.
Please note that MSAA does not endorse or recommend any specific drug or treatment. Individuals are advised to consult with a physician about the potential benefits and risks of the different treatment therapies.
For more information about approved and experimental treatments for MS, please refer to the cover story in MSAA’s Summer/ Fall 2010 Issue of The Motivator, titled “MS Research Update.”
Exacerbation Management
This second section for the treatment of multiple sclerosis (MS) refers to managing exacerbations, which are the sudden flare-up of symptoms, often lasting from one to three months. Intravenous injection (IV) and/or oral steroids are usually prescribed to minimize the effects of an exacerbation and to try to prevent any long-term damage that may be caused by an exacerbation. Exacerbations may be treated at the hospital or in one's home, where a visiting nurse may administer the IV.
Not all of these treatments are approved by the FDA (United States Food & Drug Administration) specifically for the treatment of MS. The drugs listed below were compiled by Dr. Jack Burks, MSAA's chief medical officer.
- Solu-Medrol® (IV methylprednisolone)
- Prednisone
- Decadron® (dexamethasone)
- Medrol® (oral methylprednisolone)
- Plasmapheresis (plasma exchange)*
- Intravenous immunoglobulin (IVIg) therapy*
- Acthar® Gel
*Dr. Burks notes that when using these types of therapies for the treatment with MS, the results have been mixed; studies continue to determine the effectiveness of these treatments with MS.
For more information, please visit Treating Exacerbations with Steroids in the Treatments section.
Please note that MSAA does not endorse or recommend any specific drug or treatment. Individuals are advised to consult with a physician about the potential benefits and risks of the different treatment therapies.
Treatments for Managing the Symptoms of Multiple Sclerosis
FATIGUE
- Provigil® (modafinil)
- Symmetrel® (amantidine)
- SSRI antidepressants (Prozac®, Paxil®, Zoloft®)
- Ritalin® (methylphenidate)
- Energizing" tricyclic antidepressants (Vivactil®, Pamelor®)
- Cylert® (pemoline)
SPASTICITY
- Lioresal® (baclofen)
- Zanaflex® (tizantidine)
- Klonopin® (clonazepam)
- Dantrium® (sodium dantrolene)
- Flexeril (cyclobenzaprine HCl)
- Valium® (diazepam)
- Intrathecal baclofen pump
- Botox®/Myobloc® (botulinium toxin)
For Intermittent Spasms(often at night):
- Neurontin® (gabapentin)
- Tegretol® (carbamazepine)
- Eldepryl® (selegiline)
- Sinemet® (L-dopa)
TREMOR
- Inderal® (propranolol)
- Buspar® (buspirone)
- Klonopin® (clonazepam)
- Atarax®, Vistaril® (hydroxyzine)
- Desyrel® (trazodone)
- Diamox® (acetazolamide)
- Mysoline® (pimidone)
- Isoniazid (INH) & pyridoxine
- Brain stimulation surgery
VERTIGO or DIZZINESS
- Antivert® (meclizine)
- Benadryl® (diphenhydramine)
- Dramamine® (dimenhydrinate)
- Scopolamine patch
- Benzodiazepines
- Klonopin® (clonazepam)
- Ativan® (lorazepam)
- Xanax® (alprazolam)
- Serax® (oxazepam)
- Valium® (diazepam)
DEPRESSION
Selective Serotonin Reuptake Inhibitors (SSRI):
- Paxil® (paroxetine)
- Prozac® (fluoxetine)
- Zoloft® (sertraline)
- Lexapro® (escitalopram)
- Celexa® (citalopram)
Tricyclic Antidepressants:
- Elavil® (amitriptyline)
- Pamelor® (nortriptyline)
- Tofranil® (imipramine)
- Norpramin® (desipramine)
Other Medications for Depression:
- Desyrel® (trazodone)
- Serzone® (nefazodone)
- Welbutrin® (bupropion HCl)
- Effexor® (venlafaxine)
PAIN
- Neurontin® (gabapentin)
- Lyrica® (pregabalin)
- Tegretol® (carbamazepine)
- Zanaflex® (tizanidine)
- Lioresal® (baclofen)
- Dilantin® (phenytoin)
- Cytotec® (misoprostol)
- Depakote® (valproate)
- Zostrix® (Capsaicin; topical analgesic for dysesthesia, which are uncomfortable sensations such as pins and needles feelings)
BOWEL PROBLEMS
Bulk Forming Agents
- Metamucil®
- FiberCon®
- Fiberall®
- Perdiem Plain® fiber
- Citrucel®
Stool Softeners
- Colace®
- Surfac®
- Chronulac® syrup
Oral Laxatives
- PeriColace®
- Milk of Magnesia®
Suppositories (rectal stimulants)
- Glycerin suppositories
- Ducolax® suppositories
- Therevac enemas
BLADDER PROBLEMS
Anti-spasticity Treatments
- Detrol® (tolterodine tartrate)
- Ditropan® (oxybutynin)
- Ditropan XL® (oxybutynin chloride)
- Zanaflex® (tizanidine)
- Crystospaz®, Levbid®, Levsinex® (hyoscyamine)
- Urispas® (flavoxate hydrochloride)
- Tofranil® (imipramine)
- ProBanthine® (propantheline bromide)
- Intrathecal baclofen pump
Alpha Blockers
- Hytrin® (terazosin)
- Dibenzyline® (phenoxybenzamine)
Antibiotic Bladder Agents
- Macrodantin® (nitrofurantoin)
- Cipro® (ciprofloxacin)
- Septra® (trimethoprim and sulfamethoxazole)
Other Bladder Drugs
- Pyridium® (phenazopyridine HCl)
- Urecholine® (bethanechol)
- DDAVP (desmopressin)
SEXUAL DYSFUNCTION
- Viagra® (sildenafil citrate)
- Cialis® (tadalafil)
- Levitra® (vardenafil HCI)
- MUSE® (prostaglandin)
COGNITIVE CHANGES
- Aricept® (donepezil HCl)
- Possibly other Alzheimer's drugs
Please note that MSAA does not endorse or recommend any specific drug or treatment. Individuals are advised to consult with a physician about the potential benefits and risks of the different treatment therapies.
For more detailed information on managing specific symptoms, please refer to the Winter/Spring 2009 issue of The Motivator for the "Symptom Management Update" article. You may also want to review the “Symptom Awareness” columns from the different issues of MSAA's publication, The Motivator.
