Currently, multiple sclerosis (MS) is regarded as an incurable disease but certain medications are available to suppress the symptoms associated with these disease. The medication used in this condition act mainly by stopping, or improving the activity of the body’s natural defense system (immune system) against pathogens.1

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Myelin (protective sheath of nerves) is damaged in multiple sclerosis and the therapy in this disease is targeted towards slowing down this damage, suppressing the symptoms associated with multiple sclerosis and preventing relapse (recurrence of the disease). These medications decrease the frequency of multiple sclerosis attacks thereby preventing future disability.2

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In most cases, multiple sclerosis relapse does not need medication and generally resolves by itself. But if you are in severe stage of this disease and experiencing frequent relapses then you may be prescribed with intravenous corticosteroids.3 You are an ideal candidate for disease-improving medicines if you are suffering from continuously progressing relapse-remitting multiple sclerosis. This therapy not only halts multiple sclerosis progressions but also prevent future flare-ups. One should always evaluate the efficacy of the medicine in relation to side effects associated with the medicine. The medicine should feasible with patients priorities and does not interfere with daily life of the patient.4 Although, the early administration of disease modifying therapy for controlling inflammation in multiple sclerosis is a good choice, it should be avoided in patients with progressive form of multiple sclerosis. Diagnosing the disease in early stages may provide a chance of inflammation control which results in prevention of future nerve damage in multiple sclerosis.5

What Is The Best Medicine For Multiple Sclerosis?

At present, Ocrelizumab is the approved treatment of choice for multiple sclerosis patients. Treatment with this medicine results in decrease in multiple sclerosis progression as compared to patients who are not treated. The concern with Ocrelizumab is that it has shown to increase certain cancer risk, especially breast cancer. Natalizumab, alemtuzumab and mitoxantrone are other medicines which are effective but there use is limited due to potential side effects.6

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Steroids therapy given in multiple sclerosis can only help in speeding up your recovery from a relapse, but are not known to prevent future relapses. They are prescribed for a short duration of time due to their potential side effects. Long-term use of this therapy has risk of fragile bones, obesity or weight gain and increase in blood sugar level. 1 Plasma exchange (plasmapheresis) is an option if your symptoms are new, severe and have not responded to steroids.6

Dimethyl fumarate, two times daily by oral route, is the most widely accepted medicine for treating relapsing forms of multiple sclerosis. Oral fingolimod is a medicine that modulates immune system and is used to cure relapsing forms of multiple sclerosis. Glatiramer acetate as injectable (three times a week) is commonly used to treat relapsing-remitting multiple sclerosis. Another common medicine is interferon beta-1a which is commonly used to cure relapsing forms of multiple sclerosis, and to treat after starting episode of inflammation.4

In addition to this, muscle relaxants may be used if you are experiencing painful or uncontrollable muscle stiffness or spasms, particularly in your legs. You may be prescribed with medication (like amantadine, modafinil, etc.) if you are feeling excessive tiredness. Also, anti-depression medication may be given if are also suffering from depression as a consequence of multiple sclerosis.6

Multiple sclerosis is often accompanied by leg weakness and disturbs manner of walking (gait). Physical therapy along with the use of a mobility aid may be required in these conditions.6

Conclusion

Currently there is no cure for multiple sclerosis, however, certain medication do decrease the episodes and severity of attacks and halt the progression of newer brain lesions.

References:

  1. Treatment- Multiple sclerosis. Adapted from: https://www.nhs.uk/conditions/multiple-sclerosis/treatment/ [Accessed on 04/04/2019]
  2. Treatments for Multiple Sclerosis. Adapted from: https://www.webmd.com/multiple-sclerosis/ms-treatment#1. [Accessed on 04/04/2019]
  3. Multiple sclerosis. Adapted from: https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/diagnosis-treatment/drc-20350274 [Accessed on 06/04/2019]
  4. Treating MS. Adapted from: https://www.nationalmssociety.org/Treating-MS/Medications [Accessed on 06/07/2019]
  5. Cerqueira JJ, Compston DAS, Geraldes R, et al. Time matters in multiple sclerosis: can early treatment and long-term follow-up ensure everyonebenefits from the latest advances in multiple sclerosis? J Neurol Neurosurg Psychiatry. 2018 Aug;89(8):844-850.
  6. Multiple sclerosis. Adapted from: https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/diagnosis-treatment/drc-20350274 [Accessed on 06/04/2019]

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Sheetal DeCaria MD

Written, Edited or Reviewed By:

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Last Modified On: May 11, 2019

This article does not provide medical advice. See disclaimer

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