Multiple Sclerosis Treatment

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• QWhat are the safe and effective treatments of depression in MS?

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  A Multiple Sclerosis Foundation answered

  Medication can be used to treat depression in people with multiple sclerosis (MS). Your MS doctor, primary care doctor or psychiatrist can prescribe and monitor medication to treat depression. Factors including convenience, visit frequency and severity of depression may be considerations for determining the most appropriate provider for offering depression care. Sometimes referral to another provider with expertise in addressing your unique needs is needed.

  Some people worry about the side effects of medication used to treat depression in people with multiple sclerosis (MS), such as weight gain, sexual dysfunction and drowsiness, or about adding new medication to already complex MS treatment regimens. These concerns are legitimate and should be discussed explicitly during healthcare visits.

  Of note, some medications used for depression can actually help manage MS symptoms. For example, some medications are effective at decreasing nerve pain common in MS. And while some depression medications facilitate sleep in those suffering insomnia, others can assist in promoting wakefulness and stamina. Again, honest communication with your healthcare provider can help with identifying the best medications for you.

  As with MS medications, always take depression medications as prescribed and inform a healthcare provider if problems develop. It typically takes several weeks or longer to determine a medication’s effectiveness; dose adjustments and changes in medication may be needed to provide the most symptom relief.

  Research has also found that cognitive ­behavioral therapy (CBT) is beneficial for a variety of multiple sclerosis (MS) ­related concerns, including depression, anxiety, grief and pain. CBT is an effective and widely practiced type of therapy. The basic premise of CBT is that emotions are influenced by cognitions (thoughts). When individuals have negative thoughts, they tend to experience greater despair than individuals with fewer of these thoughts. When people learn ways to balance their perspective, they often feel happier, more hopeful and less depressed, even when their situation remains unchanged.

• QHow effective are the treatments for multiple sclerosis (MS)?

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  A Sigma Nursing answered

  There are a few treatment options for people with multiple sclerosis, or MS. Medications like Copaxone, Tysabri, and others can be prescribed to help slow the progress of the disease and relieve symptoms. The most commonly prescribed medications are anti-inflammatory corticosteroids. Beyond medication, a procedure called plasma exchange separates the plasma from your blood, which can help combat more severe symptoms. Patients can also attend physical therapy to learn about tools that may help them move around such as braces or crutches, and to work with a trainer to stretch and build their muscles. Other options are available as well, so talk with your doctor about the treatment that is right for you.

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• QAre there alternative treatments for multiple sclerosis?

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  A Dr. Charles R. Smith, MD , Neurology, answered on behalf of Scripps Health

  

  Many alternative therapies haven't been proven to help. In this video, neurologist Charles Smith, MD, explains why you should avoid alternative or complementary therapies in lieu of traditional treatment.

  

  Find out more about this DVD:

  Can Alternative Therapies Help Manage Multiple Sclerosis?
  Buy DVD

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• QWhat types of medications treat multiple sclerosis (MS)?

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  A Multiple Sclerosis Foundation answered

  Multiple sclerosis (MS) has been categorized into four clinical courses: relapsing-remitting, secondary progressive, primary progressive, and progressive relapsing.

  • Relapsing-remitting MS (RRMS), which is characterized by clearly defined acute attacks, is the most common form of the disease. Individuals with RRMS benefit most by treatment with the interferon drugs or glatiramer acetate, also known as the ABCR drugs (Avonex, Betaseron, Copaxone and Rebif). Tysabri may be another treatment option.
  • Secondary progressive MS (SPMS) initially begins with a relapsing-remitting course, that later becomes consistently progressive at a variable rate. Although some of the ABCR drugs, especially the interferons, may help control this more progressive form of MS, chemotherapeutic agents, such as Novantrone, are often the most helpful medications available. Tysabri also may be an option for those still experiencing relapses. Using medication for optimal management of symptoms such as spasticity, fatigue and bladder problems, can significantly improve a person's quality of life.
  • Primary progressive MS (PPMS) is characterized by progression of disability from the onset, primary progressive MS worsens without any distinct relapses or remissions. There are no known treatments for this form of MS, although some MS experts advocate pulse steroids during the first few years of the disease. Symptom management, however, can be very helpful in maintaining and improving quality of life, as disease progression tends to be slow.

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• QHow do interferon drugs help treat multiple sclerosis (MS)?

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  A Multiple Sclerosis Foundation answered

  Avonex, Betaseron and Rebif are all interferon beta products. While their exact mechanism of action for treating multiple sclerosis (MS) is unknown, there are several hypotheses regarding how they work. In theory, the interferon drugs seal off the blood brain barrier and inhibit the T cells from being activated. This prevents the T cells from entering the central nervous system (CNS) and destroying myelin, and ultimately, the nerve axons.

  The interferon beta 1-a (Avonex, Rebif) and interferon beta 1-b (Betaseron, Extavia) drugs for multiple sclerosis (MS) have flu-like symptoms following injection, which can be minimized by taking acetaminophen (Tylenol), naproxen (Aleve), or ibuprofen (Advil or Motrin). Their less common side effects include allergic reactions, depression, suicidal ideas, liver and thyroid functions affected (altered thyroid test and elevated liver enzymes), and low red or white blood cell counts.

  Because they affect the liver, you may bruise more easily or your skin may change color (make sure you inform your doctor). Avonex has been associated with heart problems, although it's not clear that the drug was the culprit. Since they are all injected, you may have localized reaction in the injection site like redness in the skin, bumps, bruises, pain and infections. Learning how to correctly inject yourself or using autoinjecting devices may help to minimize these effects.

• QIs there a cure for multiple sclerosis?

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  A Multiple Sclerosis Foundation answered

  There is no cure for multiple sclerosis (MS), but scientists and researchers around the world are working diligently to decipher the complexities of this disease. There are injectable treatments designed to reduce the frequency of attacks and delay the progression of disability. There are also many medications available to treat the symptoms of the disease.

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• QHow can I learn to give myself a shot of multiple sclerosis medication?

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  A Multiple Sclerosis Foundation answered

  If you have multiple sclerosis (MS), giving yourself a shot on a regular basis can be challenging. At first, it may feel frightening or awkward, but choosing and staying on a therapy for MS can also be empowering. You are in charge of your health. Treating MS is a long-term commitment and a good support team provides you with the encouragement you need at all stages of that journey.

  Needles for intramuscular injections for multiple sclerosis (MS), such as those for Avonex, are 1.25 inches long; the sub-cutaneous needles used for Betaseron, Copaxone and Rebif, are a half-inch long. You may find that a thinner needle is less painful. Betaseron recently introduced a 30 gauge needle comparable to those used by diabetics.

  You can get more tips on your technique at an MS Center, at your neurologist's office or through a nurse specially trained in MS. Starting with proper training, an MS nurse can teach you to overcome fears and be confident when giving yourself injections. Whether you are just starting on treatment or have been taking a disease-modifying drug (DMD) for years, these experts can offer assistance, answer questions and help you manage your medication. When things get hard, they are there to cheer you on. After a while, you will feel more self-assured and not need as much support.

• QWhat is steroid therapy for multiple sclerosis (MS)?

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  A Multiple Sclerosis Foundation answered

  Steroid therapy is most commonly used for relapse management of multiple sclerosis (MS). Steroids may shorten the duration of relapse symptoms, but do not alter the ultimate outcome of the disease. There are many different regimens used for relapse management. In the United States, intravenous (IV) methylprednisolone or Solumedrol, with or without a prednisone taper, is typical.

  In Canada, oral steroids are more commonly used. Studies have shown that oral steroids may be as effective as IV steroids and have similar side effects. Adrenocorticotrophic hormone
  (ACTH) is another option for relapse management. This is a hormone that stimulates natural steroid production. The standard protocol calls for a two-week tapering course of intramuscular injections, but shorter doses administered subcutaneously have also been shown to be effective.

• QHow is multiple sclerosis (MS) treated?

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  A NewYork-Presbyterian Hospital answered

  Because MS is such as variable disease, treatment for each patient is highly individualized. For most patients, treatment is likely to include some combination of medications. These include:

  • Drugs that modify the course of the disease. Medications currently approved by the Food and Drug Administration are beta interferons including Avonex®, Betaseron®, and Rebif®; glatiramer acetate (Copaxone®); natalizumab (Tysabri®); and mitoxantrone (Novantrone®).
  • A variety of therapies that alleviate the daily symptoms of MS (fatigue, depression, bowel and bladder problems, pain, numbness, tingling, stiffness, spasms, cognitive problems, weakness and sexual problems) are integral to the treatment of MS.
  • Intravenous anti-inflammatory corticosteroids can hasten recovery from acute relapses.

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