Multiple sclerosis-Treatments and drugs-By Mayo Clinic staff

Treatments and drugs

There is no cure for multiple sclerosis. Treatment typically focuses on strategies to treat attacks, to modify the course of the disease and to treat symptoms. Some people have such mild symptoms that no treatment is necessary

Strategies to treat attacks

Corticosteroids. The most common treatment for multiple sclerosis, corticosteroids reduce the inflammation that spikes during a relapse. Examples include oral prednisone and intravenous methylprednisolone. Side effects may include increased blood pressure, mood swings and weight gain. Long-term use can lead to cataracts, high blood sugar and increased risk of infections.
Plasma exchange (plasmapheresis). This procedure looks a little like dialysis as it mechanically separates your blood cells from your plasma, the liquid part of your blood. Plasma exchange is sometimes used to help combat severe symptoms of multiple sclerosis relapses in people who aren't responding to intravenous steroids.

Strategies to modify the course of the disease

Beta interferons. These types of drugs — such as Avonex, Betaseron, Extavia and Rebif — appear to slow the rate at which multiple sclerosis symptoms worsen over time. Interferons can cause side effects, including liver damage, so you'll need blood tests to monitor your liver enzymes.
Glatiramer (Copaxone). Doctors believe that glatiramer works by blocking your immune system's attack on myelin. You must inject this drug subcutaneously once daily. Side effects may include flushing and shortness of breath after injection.
Fingolimod (Gilenya). An oral medication given once daily, this works by trapping immune cells in lymph nodes. It reduces attacks of MS and short-term disability. To take this drug, you'll need to have your heart rate monitored for six hours after the first dose because the first dose can slow your heartbeat (bradycardia). You'll also need to be immune to the chickenpox virus (varicella-zoster virus). Other side effects include high blood pressure and visual blurring.
Natalizumab (Tysabri). This drug is designed to work by interfering with the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. Tysabri is generally reserved for people who see no results from or can't tolerate other types of treatments.
This is because Tysabri increases the risk of progressive multifocal leukoencephalopathy — a brain infection that is usually fatal.
Mitoxantrone (Novantrone). This immunosuppressant drug can be harmful to the heart, and it's associated with development of blood cancers like leukemia, so it's usually used only to treat severe, advanced multiple sclerosis.
Strategies to treat symptoms
Physical therapy. A physical or occupational therapist can teach you stretching and strengthening exercises, and show you how to use devices that can make it easier to perform daily tasks.
Muscle relaxants. If you have multiple sclerosis, you may experience painful or uncontrollable muscle stiffness or spasms, particularly in your legs. Muscle relaxants such as baclofen (Lioresal) and tizanidine (Zanaflex) may improve muscle spasticity. Baclofen may increase weakness in the legs.
Tizanidine may cause drowsiness or a dry mouth.
Medications to reduce fatigue. Drugs such as amantadine (Symmetrel) may help reduce fatigue.
Other medications. Medications may also be prescribed for depression, pain and bladder or bowel control problems that may be associated with multiple sclerosis.

A number of other drugs and procedures such as stem cell transplantation to treat multiple sclerosis are under investigation

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