Multiple Sclerosis Treatments: What to Take, What to Do

There is no cure for MS. But there are options available to treat symptoms, relapses, and the course of the disease.

To keep things simple, there are three groups of treatments, all with a different purpose: medications, corticosteroids, and disease-modifying agents.

• Medicine

These are used to treat the symptoms of MS, and the use can be short-term or long-term. They minimize the intensity or effect of symptoms so that quality of life and daily function are more manageable. Examples include antidepressants for depression, Baclofen for spasticity, Ditropan for incontinence, etc.

• corticosteroids

Corticosteroids (“steroids”), usually Solu-Medrol and prednisone, are used to reduce the length and severity of a flare-up (or flare-up or attack). The administration of these drugs is in high doses for a short period (from three days to several weeks).

• Disease Modifying Agents (DMA)

Disease-modifying agents (also known as DMD disease-modifying drugs) reduce the progression and activity of the disease. The FDA has approved nine of them to date, and a lot of research is going on to continue to find more. Most of them are for patients who have the relapsing-remitting type of MS, or for those who have the secondary progressive type who continue to relapse.

Most people with MS have used drugs in at least two of these categories. Some work for some people and some don’t work at all for others. If you try one drug and it doesn’t work, then you can try another. Each person responds to drugs differently.

Medications and corticosteroids have been tested and used for decades. Disease-modifying agents became available in the 1990s. Today, as I participate in online discussions and forums, it seems almost everyone with MS is in one of these. Neurologists and the MS Society strongly recommend that patients get one as soon as possible.

But taking DMA is a difficult regimen. They have side effects, require a lot of follow-up (doctor visits, MRIs, clinic visits…) and are expensive. While some patients obtain financial assistance through pharmaceutical companies, participating in a clinical trial, etc. many others pay thousands of dollars a year out of pocket.

News broke last July that a study suggested that interferons did not slow the progression of MS, the basis of many AMD. This news was startling to many in the MS community: “Wow! Can this be true? After all those years of injections, tests, office visits, side effects, dollars spent… now what?” And what does a newly diagnosed person have to do now to start an interferon?

First, don’t panic. I, and others I know, have lived with MS for over thirty years and have never had an DMA for various reasons. We’ve managed pretty well. Over the years, I have personally taken medications and steroids to help with symptoms and relapses. However, I would never advise anyone not to take a particular treatment. That is a personal decision.

So what is to be made of the recent news about interferons?

Every time I have considered taking any medication over the years, I have followed these steps and offer them for patient consideration:

• Be sure to thoroughly research the studies on a drug before taking one. Make it from a variety of sources. Carefully evaluate the studies behind the drug: number of people involved, length of study, type of study, etc.

• If you are taking a medication, do the benefits outweigh the risks? what are the lengths–long-term risks of a treatment, especially if you are a very young person?

• Doctors are not always right. People with MS should consult with their doctors, but those with MS know their body best and should have the final say.

• Take your time to make a decision. A delay of several weeks or months will make little difference to the general course of your MS. Use common sense and remember that this is your body and ultimately your personal decision.

There is no magic pill or injection to make MS go away. However, there are many other things that someone can do to manage MS effectively to complement any medication that is taken. Examples include health and wellness actions (exercise, sleep, stress management…) and alternative therapies (massage, yoga, pilates… ). These can start today!