Recognized treatment in multiple sclerosis (published with the translation of MSIF)
As there is no medicine that can cure MS, there are some aspects of the disease for which there are treatments that can be recognized as being very effective.
Exacerbations
The standard treatment for acute exacerbations is the anti-inflammatory steroidal, acting through strong anti-inflammatory effect. Steroids reduce inflammation at the new demyelination, allowing faster return to normal function, reducing the exacerbation period. The most used steroidian treatment is methyl-prednisolone in high doses intravenously for 3 to 5 days, treatment usually completed by 1-2 weeks of oral prednisone. It is consider that the use of steroids has no effect on long-term evolution of disease.
Changing of the disease course
Several new drugs have recently been approved for MS treatment, drugs that affect the frequency and severity of exacerbations, also on the number of lesions visible on MRI. However, the effect on the progress of disability is still unclear.
General Therapies change the course of the disease:
- Glatiramer acetate (Copaxone)
- Interferon beta-1a (Avonex)
- Interferon beta-1a (Rebif)
- Interferon beta-1b (Betaseron or Betaferon)
- Mitoxantrone (Novantrone)
Acute exacerbations
- Dexamethasone (Decadron)
- Methylprednisolone (Depo-Medrol)
- Prednisone (Deltasone)
U.S. National Society website includes a comparison of MS drugs that modify the SM.
Specific symptomatic treatment
For many of the symptoms that occur in MS effective treatments exist. It is important that the diagnostic tests and re-evaluation of symptoms to be made with a competent physician (family doctor, neurolg or other specialists such as urologists, gynecologists, etc.). The "MS: The Guide to Treatment and Management" (MS: Guide to treatment and disease management) a large number of such therapies are stated, and evidence of the indications, application and efficiency are discussed in detail.
MS: Guide (will be available soon from the Library section)
Spasticity
- Baclofen (Lioresal)
- Clonazepam (Klonopin or Rivotril)
- Dantrolene (Dantrium)
- Diazepam (Valium)
- Gabapentin (Neurontin)
- Tizanidine (Zanaflex)
- Tremor Clonazepam (Klonopin or Rivotril)
- Isoniazid (Laniazid).
Fatigue
- Amantadine Fluoxetine (Prozac)
- Modafinil (Provigil)
- Pemoline (Cylert)
Bladder dysfunction
- Ciprofloxacin (Cipro)
- Desmopressin (DDAVP nasal spray)
- Imipramine (Tofranil)
- Methenamine (Hiprex, Mandelamine)
- Nitrofurantoin (Macrodantin)
- Oxybutynin (Ditropan)
Digestive system disorders
- Bisacodyl (Dulcolax)
- Docusate (Colac)
- Docusate mini enema (Therevac Plus)
- Glycerin (Supple Breasts-supository)
- Magnesium hydroxide (Milk of Magnesia Phillips)
- Mineral oil Psyllium hydrophilic mucilloid1
- Sodium phosphate (Fleet Enema)
Sexual dysfunction
- Alprostadil (Prostin)
- Alprostadil (MUSE)
- Papaverine Sildenafil (Viagra)
- Pain Amitriptyline (Elavil)
- Carbamazepine (Tegretol)
- Clonazepam (Klonopin or Rivotril)
- Gabapentin (Neurontin)
- Imipramine (Tofranil)
- Nortriptyline (Pamelor or Aventyl)
- Phenytoin (Dilantin)
Cognitive dysfunction,
- Psychiatric and psychological Bupropion (Wellbutrin)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Venlafaxine (Effexor)
- Vertigo & Dizziness Meclizine (Antivert or Bonamine)
Sensitivity to temperature & Tingling
- Hydroxyzine (Ataraxia)
Nausea & vomiting
- Meclizine (Antivert or Bonamine)
Rehabilitation and disease management
When there is no way to improve a physiological function, people with MS should try to optimize their physical, mental and social condition. After an exacerbation is likely to need rehabilitation. During the period of remission persons with MS should participate in a program of therapy to achieve and to sustain physical condition to an optimal capacity. Therapy may consist of physiotherapy, stretching, coordination exercises, exercises for swallowing and speech. The program may also include medication, adequate nutrition and counseling. You may need lifestyle changes (both social and occupational).
