Multiple sclerosis (MS) is a disease of the central nervous system that affects about 1 million Americans.
MS can cause recurring symptoms with vision, sensation, strength, balance and coordination, mood, cognition, and more in some patients. It leads to long-term disability in some.
There is no cure for MS, but you potentially can manage it with treatment. Improvements in diagnosis and treatment are helping people with MS get a better prognosis and higher quality of life.
“We have a lot of better tools nowadays,” says Rock Heyman, MD, associate professor and chief of the Division of Neuroimmunology and Multiple Sclerosis in the Department of Neurology at University of Pittsburgh’s School of Medicine.
A combination of medicine and lifestyle changes may help you manage your MS more effectively.
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What Medicines Treat Multiple Sclerosis?
Medication can be helpful to modify the course of MS, treat relapses, and help with symptoms, the National Multiple Sclerosis Society says.
Treatment options to control the disease itself include injectable, oral, and infusion medicines. Which medicine you receive depends on several factors, including your level/type of MS, other medical problems, risk tolerance, and potential side effects.
“You want balance,” Dr. Heyman says. “You want a strong medicine, but you also want to balance treatment risks and side effects with what the patient needs. What are the patient’s risk factors for progression? Does the patient plan a pregnancy soon? What is their tolerance for risk and side effects?”
The goal of these medicines is to decrease the rate of exacerbations, rate of disability progression, and MRI changes, including new lesions and brain atrophy.
Given by self-injection, these medications became the first long-term treatments for MS in the 1990s.
Most injectable medications fall under the category of “interferon beta,” a man-made version of a protein your body makes to control your own response to viral infections.
“Interferon beta are more modest in their effects on MS and in many patients can cause fever, chills, muscle aches, and aggravate fatigue or mood,” Dr. Heyman says.
Another injectable medicine is glatiramer acetate, which also is a more modestly potent medication but doesn’t cause the same side effects. Dr. Heyman says it is the only MS medication that appears safe to use during pregnancy and breastfeeding.
Oral medicines for MS first became available in 2010, providing a potentially more convenient option for patients. Although Dr. Heyman says oral medicines tend to be stronger against MS than injectable medications, they also carry potential side effects. While injectable medications modify the immune system, oral medications can be immunosuppressive. That leaves people more at risk for infection or other problems. Different oral medications have different risks and side effects. Knowledge of the different options helps you and your neurologist choose a treatment option that may be the best fit for you.
Doctors also can prescribe infusion medications for MS.
While people with MS can take injectable or oral medications at home, doctors deliver infusion medications via IV at a health care facility.
Dr. Heyman says infusion medicines are usually the strongest for MS. Like oral medications, they are immunosuppressive and can cause serious side effects in some patients.
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Managing Multiple Sclerosis
While medicine is a key treatment for MS, it’s not the only way patients can manage their disease and its symptoms.
One key lifestyle change is exercise.
“Exercise makes a difference at all levels, whether it’s mild, moderate, or severe MS,” Dr. Heyman says. “We try to use getting a diagnosis a reason to develop good exercise habits. Oftentimes a physical therapist or trainer can assist in developing an appropriate exercise regimen.”
Dr. Heyman says regular exercise can reduce the disease’s abnormal activity and improve quality of life.
Other steps that people can take include quitting smoking and taking vitamin D supplements. Stopping smoking will lower the risk for MS disability progression. Dr. Heyman believes that maintaining good vitamin D levels has also been shown to decrease the rate of MS exacerbations in some studies.
You also should pay attention to your mental health. Untreated anxiety and depression will make it harder to be successful with your MS care and lower your quality of life.
Treating Multiple Sclerosis Symptoms
There are many different ways to try to limit the impact of symptoms from prior MS damage. Many different options exist to help lessen the impact of weakness, bladder control issues, mood, pain, fatigue, and other symptoms. People can see some of these options from the National Multiple Sclerosis Society (NMSS) or the Pittsburgh Institute for Multiple Sclerosis Care and Research.
Dr. Heyman says people with MS should seek resources like the NMSS to learn about the disease and management.
For more information, visit Pitt’s Division of Neuroimmunology and Multiple Sclerosis.
“Learning about MS is important,” Dr. Heyman says. “It’s a scary and sometimes complicated disease, but we have many ways to help people be successful.”
The UPMC Department of Neurosurgery is the largest academic neurosurgical provider in the United States. We perform more than 11,000 procedures each year. We treat conditions of the brain, skull base, spine, and nerves, including the most complex disorders. Whether your condition requires surgery or not, we strive to provide the most advanced, complete care possible. Our surgeons are developing new techniques and tools, including minimally invasive treatments. U.S. News & World Report ranks neurology and neurosurgery at UPMC Presbyterian Shadyside as among the best in the country. We also rank among the top neurosurgery departments in the U.S. for National Institutes of Health funding, a benchmark in research excellence.