Multiple Sclerosis (cont.)

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How are the physical manifestations of multiple sclerosis treated?

There are numerous medications that are used to manage complications associated with MS. The following table lists common complications, examples of drug and non-drug therapies, and comments about complications and/or management. Among these, only dalfampridine (Ampyra) has been approved by the FDA as a symptomatic (non-DMD) treatment for MS.

Multiple Sclerosis Complications with Examples of Drug and Nondrug Management*
Complication Drugs Nondrug Management and Comments
Difficulty walking (slowness) Dalfampridine (Ampyra) Dalfampridine (Ampyra) was FDA-approved in 2010 to improve walking in patients with MS. Physical therapy, orthotic equipment, and walking aids also may be of benefit.
Muscle spasticity Baclofen (Lioresal)
Tizanidine (Zanaflex)
Diazepam (Valium)
Clonazepam (Klonopin)
Dantrolene (Dantrium)
Physical therapy also may provide benefit. Most drugs are given by mouth. Some drugs are given via spinal pumps.
Weakness None Physical therapy and exercise are used primarily. Foot braces, canes or walkers are of benefit.
Eye problems (acute optic neuritis) Methylprednisolone (Solu-Medrol) Solu-Medrol is given during the acute attack intravenously, sometimes followed by a corticosteroid by mouth.
Fatigue, emotional outbursts Antidepressants
Amantadine (Symmetrel) for fatigue;
Modafinil (Provigil) for fatigue
Decrease or avoid physical activity and heat exposure. Amitriptyline is used for sudden laughing/weeping.
Pain Aspirin
Aspirin, NSAIDs, acetaminophen, or physical therapy are used for muscle and back pain. Anticonvulsants, like carbamazepine (Tegretol) or gabapentin (Neurontin) are used for face or limb pain. Antidepressants or electrical stimulation are used for prickling pain, intense tingling, and burning. Referral to pain specialist is recommended with severe pain.
Bladder dysfunction Antibiotics
Vitamin C
Oxybutynin (Ditropan)
Antibiotics are used to manage infections.
Vitamin C and cranberry juice are used to prevent infections.
Catheters are used to relieve retention of urine. Oxybutynin (Ditropan, Ditropan LX, Oxytrol) or tolterodine (Detrol, Detrol LA) is used for bladder dysfunction.
Constipation Increase fluids and fiber.
Sexual dysfunction Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)
Vaginal gels
For males, erectile dysfunction drugs, papaverine, penile implant, or electrostimulation are used. For females, vaginal gels or a vibrating device are used.
Tremors Often resistant to treatment. Sometimes drugs or surgery are used if tremors are severe.
*This list is not exhaustive; most of the drugs listed below are used to treat multiple sclerosis symptoms even though they have not been FDA-approved for these particular purposes.

What are the future directions for managing multiple sclerosis?

There is a great deal of ongoing research in multiple sclerosis, and there continues to be a focus on the immune system in investigational therapies. In addition, scientists are trying to develop techniques that allow brain cells to generate new myelin or that prevent the death of nerves. Other promising approaches include the use of precursor (neuronal stem or progenitor) cells that could be implanted into the brain or spinal cord to repopulate areas of missing cells. Future therapy may involve methods designed to improve impulses traveling over the damaged nerves. Scientists also are exploring the effects of diet and other environmental factors on multiple sclerosis.

Medically reviewed by Jon Glass, MD; American board of Psychiatry and Neurology

Medically Reviewed by a Doctor on 8/1/2014

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Multiple Sclerosis - Symptoms Question: The symptoms of multiple sclerosis can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Multiple Sclerosis - Treatments Question: How do you manage your multiple sclerosis?
Multiple Sclerosis - Diagnosis Question: How many doctors did you go to before you received a multiple sclerosis diagnosis?
Multiple Sclerosis - Causes Question: Were you, a friend, or relative diagnosed with MS? What do you think the cause might be?
Multiple Sclerosis - Type Question: What type of multiple sclerosis do you have? How do you cope with the symptoms and your condition?