How are the manifestations of multiple sclerosis treated?

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How are the manifestations of multiple sclerosis treated?

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There are numerous medications that are used to manage complications associated with multiple sclerosis. 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 multiple sclerosis.

Table. Multiple sclerosis complications with examples of drug and non-drug management (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).

Complication	Drugs	Non-drug management and comments
Difficulty walking (slowness)	dalfamipridine (Ampyra)	dalfamipridine (Ampyra) was FDA- approved in 2010 to improve walking in patients with MS. Physical therapy, orthotic equipment, and walking aids also my 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	outbursts Anti-depressants 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 Ibuprofen acetaminophen anti-convulsants anti-depressants	Aspirin, NSAIDs, acetaminophen, or physical therapy are used for muscle and back pain. Anti-convulsants, like carbamazepine (Tegretol) or gabapentin (Neurontin) are used for face or limb pain. Anti-depressants 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), papaverine, 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 answer should not be considered medical advice...This answer should not be considered medical advice and should not take the place of a doctor’s visit. Please see the bottom of the page for more information or visit our Terms and Conditions.

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