What medications treat cognitive symptoms of multiple sclerosis?

No medication has been specifically approved by the U.S. Food and Drug Administration (FDA) for the treatment of cognitive (thinking and knowing) dysfunction in multiple sclerosis (MS), but some healthcare providers have found that drugs already on the market for other problems can sometimes help.

Many doctors prescribe donepezil (Aricept), a medication developed to treat memory problems associated with Alzheimer’s disease, in the hope that the drug will have the same effect in MS. A similar drug, memantine (Namenda), also is used. Because these drugs have not gone through the clinical trial process specifically to be prescribed for use in MS, this is known as an “off­label use” of the medication. The evidence for the success of an off­label usage is purely anecdotal.

Less study has been done on impact of the disease­modifying drugs (Avonex, Betaseron, Copaxone, Rebif, Tysabri and Novantrone) on the cognitive aspects of MS, but research continues on the possible benefits of each one. For example, studies show that Avonex appears to have some impact on slowing the rate of decline in processing speed, memory, executive functioning and visuospatial ability. Some beneficial effect on memory has been noted with one to three years of treatment with Betaseron. Overall, however, results have been inconclusive. 

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