What You Need to Know About Multiple Sclerosis Medication

Multiple sclerosis is an autoimmune disorder that could cause disability and decreased quality of life. While this condition has no cure, medication can greatly help reduce the severity of symptoms, speeding up recovery from attacks, preventing relapses and slowing disease progression.

In this article, we will discuss the different types of multiple sclerosis medication, whether there is a "best" medicine for multiple sclerosis and what factors may affect the course of your treatment.

Commonly Prescribed Multiple Sclerosis Medication

Multiple sclerosis treatment typically involves more than one type of medication, which can be categorized broadly into three:

1. Medication for attacks
2. Medication to alter the course of the disease
3. Medication for managing symptoms

Medication for Attacks

People with multiple sclerosis often experience long periods wherein they don't have any symptoms. However, at other times, they could have an attack, also called a relapse, exacerbation or flare-up.

During a multiple sclerosis attack, existing symptoms could worsen, and new symptoms could develop. These may include:

• Pain
• Increased fatigue
• Muscle spasms
• Tingling or numbness ("pins and needles")
• Tremors
• Balance problems
• Blurry vision
• Difficulty concentrating

Mild symptoms might not need treatment. However, if you have severe symptoms that interfere with your ability to perform your daily activities and affect your quality of life, your doctor may prescribe a short course of corticosteroids. This type of multiple sclerosis medication helps reduce nerve inflammation and shorten the duration of your relapse.

The corticosteroids commonly prescribed for multiple sclerosis attacks include:

• Intravenous methylprednisolone (Solu-Medrol®)
• Oral prednisone (Deltasone®)

Medication to Alter the Course of the Disease

Disease-modifying treatments (DMTs) are a kind of multiple sclerosis medication that aim to change the progression of the disease for the better. They typically do not improve current symptoms. However, they may help:

• Reduce the risk of relapses
• Slow down the progression of the disease
• Reduce inflammation
• Prevent new brain lesions from forming.

DMT options include the following:

*Generic only

Medication for Managing Symptoms

Multiple sclerosis results in various signs and symptoms. The following are some common symptoms of multiple sclerosis and the medications typically prescribed to address them.

Fatigue

• Modafinil (Provigil®)
• Fluoxetine (Prozac®)
• Methylphenidate (Ritalin®)

Pain

• Duloxetine (Cymbalta®)
• Oxcarbazepine (Trileptal®)
• Lamotrigine (Lamictal®

Bladder Dysfunction

• Mirabegron (Myrbetriq®)
• Imipramine (Tofranil®)
• Tamsulosin (Flomax®)

Additional Medication for Bone Health

Multiple sclerosis patients who are unable to perform weight-bearing activities such as walking and climbing as well as those who have used corticosteroids for extended periods are at increased risk of osteoporosis. As a result, they may be prescribed medications to improve bone density. Some examples are:

Factors Doctors Consider When Prescribing Medicine for Multiple Sclerosis

Some patients might ask "what is the best medicine for multiple sclerosis?"

There is no one answer to this question. Multiple sclerosis presents differently from person to person, and what is the "best" medicine for multiple sclerosis for one patient might not work as well on another. Additionally, because this condition affects people in different ways, there is no one-size-fits-all approach to treatment.

If you have been diagnosed with multiple sclerosis, you may be prescribed one or more of the aforementioned types of multiple sclerosis medicine. Factors that your doctor may consider when prescribing your medication include:

• Safety
• Efficacy
• Route of administration
• Common side effects
• Tolerability
• Lifestyle
• Patient preferences
• The type of multiple sclerosis you have

Your doctor might not consider the cost of medication, so if this is a concern, don't hesitate to bring it up with them. They could prescribe lower-cost alternatives such as generic medication or advise you on other measures to reduce your medication expenses, such as joining discount card programs.

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Taking your multiple sclerosis medication is critical to help address symptoms and change the course of your condition. While it can be costly, it's important not to alter or stop your medication, as this puts you at risk of relapse or worsening symptoms.

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Sources:

• https://www.webmd.com/multiple-sclerosis/recognize-ms-attack
• https://pubmed.ncbi.nlm.nih.gov/19566504/
• https://www.nationalmssociety.org/Treating-MS/Managing-Relapses
• https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/diagnosis-treatment/drc-20350274
• https://multiplesclerosisnewstoday.com/treatments-that-modify-the-disease-course/
• https://www.abovems.com/en_us/home/ms-treatment-journey/about-ms-treatment/disease-modifying-therapies.html
• https://www.aan.com/Guidelines/Home/GetGuidelineContent/900