Multiple Sclerosis Therapies Explored
Multiple Sclerosis (MS), a complex neurological disorder, requires careful management and a personalised treatment plan. Here's a look at some common strategies and treatments for managing MS.
Corticosteroids, such as methylprednisolone and prednisone, are often recommended to ease inflammation and reduce the severity of MS attacks. These medications are used to control symptoms and manage the disease progression.
People with MS may experience fatigue, and exercise, including physical therapy (PT), is important. A carefully tailored exercise program can benefit some people with MS, with factors including short session times and gradual increase in exercise. Exercise can help improve physical symptoms, emotional outlook, and combat fatigue.
In addition to corticosteroids, there are various medications available for managing MS-related symptoms. For instance, muscle relaxants may be prescribed to help with symptoms such as pain, muscle spasms, and fatigue. Drugs for muscle stiffness include baclofen, cyclobenzaprine, diazepam, and tizanidine.
Over-the-counter stool softeners may be recommended to help ease constipation and bowel symptoms associated with MS. Plasmapheresis, a procedure that involves removing whole blood from the body, filtering it, and returning it to reduce antibodies attacking the nervous system, is another treatment option.
When it comes to bladder problems related to MS, more than a dozen prescription medications are available. Amantadine hydrochloride (Gocovri) and amphetamine-dextroamphetamine (Adderall) are sometimes used off-label to treat fatigue in people with MS. Modafinil (Provigil) is a drug used to treat fatigue in people with MS as well.
Intravenous immunoglobulin (IVIG) is a treatment that helps modify abnormal inflammation mediated by the immune system. However, its benefits for MS relapses have been inconsistent. ACTH (H.P. Acthar Gel) is an injection that helps reduce inflammation in the body.
The FDA has approved over 20 disease-modifying therapies (DMTs) for multiple sclerosis. These include ocrelizumab (a B cell-depleting therapy) available as an infusion, and oral medications like ozanimod (Zeposia) approved for relapsing forms of MS. A new BTK inhibitor tolebrutinib is under review, potentially available orally for non-relapsing secondary progressive MS.
It's also important to address the emotional aspects of living with MS. Fluoxetine (Prozac) may be prescribed since it helps address both fatigue and depression.
During a relapse, PT can prevent muscle contractions and atrophy due to immobility. Remember, every person's experience with MS is unique, and a treatment plan should be developed with a doctor to address medical issues and improve physical symptoms and emotional outlook for people with MS.
Common side effects of MS treatments include nausea, headaches, increased risk of infections, and flu-like symptoms related to infections. It's crucial to discuss these potential side effects with your doctor to manage them effectively.
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