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Medication for MS

Medication can help to get MS symptoms under control and can reduce relapse rates and slow disease progression.

Taking medication that is agreed with your Healthcare practitioner is not in conflict with the Overcoming MS Program. We advocate doing whatever you can to lead a better, healthier life with MS. For some people medication will complement the lifestyle approach endorsed by Overcoming MS, for others, medication is simply not the right personal choice; both should be respected.

Many medications are used to treat MS, that is to slow the disease progression, and/or treat symptoms of the condition, but none of them can claim to cure the disease.

Evidence shows that a healthy lifestyle, including stopping smoking, regular exercise and a high quality diet can slow the progression and manage MS symptoms, so combining lifestyle changes with medication provides a holistic approach.

How can MS medication help?

There are two groups of medication in the management of MS; symptom control and disease-modifying therapies (DMTs).

Symptom management means trying to reduce or eliminate a particular symptom such as using pain relief for pain, laxatives for constipation, muscle relaxants for contractions. It does this without altering the underlying disease process or cause.

Disease-modifying therapies (DMTs) are used with the aim of delaying relapses and slowing the rate of disease progression and disability. Unfortunately, those that are most effective at reducing disease activity come with a more significant side effect profile and the need for close monitoring for complications.

Most MS authorities now recommend DMTs should begin as soon as possible after diagnosis, with the aim of reducing disease activity at an early stage, therefore minimising the number of relapses, and hopefully also any longer-term disability progression.

What's changing in medication for MS

The therapeutic landscape in MS is changing rapidly, with more effective drugs for RRMS, and therapies slowly becoming available to treat PPMS and SPMS:

  • Steroids shorten the recovery time from a relapse, but have no effect on residual disability levels, and should not be used in the long-term.
  • Disease modifying drugs (DMDs) can now significantly reduce relapse rates.
  • Evidence is now showing that even the first-line DMDs have an effect on long-term disease progression, and the early data on the second generation drugs looks more promising.
  • Generally, the more effective the DMD, the greater its side-effect profile and risks.
  • The potential benefits must be weighed up against the risks of a particular DMD, and medication may not be the right option for everyone with MS.
  • At present, no DMD can claim to “cure” MS, and comprehensive lifestyle changes remain a cornerstone of management.

Take a look at our short illustrated video:

MS medications: Everything you need to know

The following medications are commonly used to treat multiple sclerosis (or have in the past, some have been discontinued). 

Follow the links below for more information about these medications, which types of MS they treat, their side effects, action, background and relevant studies. 

MS medication side effects

If you read through the accompanying information for any medication you will always see possible side effects listed. However, with MS medications, the side effects can range from mild to severe.  As some MS medications can potentially cause harm, your MS team will monitor your health closely with regular blood tests and MRI scans. 

Some possible side effects, depending on the medication, include: 

  • Hair loss and nausea 
  • A change to your heart rate  
  • Flu-like symptoms   
  • Brain infection
  • Chest pain

Infusions for MS

Infusion therapies can be used to treat MS relapses that don’t respond to corticosteroids.  Intravenous immunoglobulin (IVIG) via a drip helps to boost your immune system and plasmapheresis filters your blood to remove damaging antibodies after which the ‘clean’ blood is put back into your body through a blood transfusion. 

The following disease-modifying drugs are also given intravenously: 

Ocrelizumab (Ocrevus) — you receive this drug in two doses separated by two weeks at first, then you have infusions every six months. It is the first drug to be approved for primary progressive MS (PPMS) and targets damage-causing B lymphocytes.

Alemtuzumab (Lemtrada) — given once a day for five days, then you receive it again over three days, 12 months later. The drug reduces your white blood cells to reduce damage to nerve cells and inflammation (specifically reducing the number of T and B lymphocytes).

Natalizumab (Tysabri) — you receive this drug once a month. It stops immune cells from entering your spinal cord and brain and causing damage. 

As with all medication, there are possible side effects for each drug including reactions like nausea or fatigue. The side effects also include health issues as a direct result of the infusion process itself including skin reactions, chills, and bruising and bleeding at the injection site. There are also serious side effects which include potentially life-threatening instances of organ failure and cancer, depending on the drug being received. Like with any medicine, it is administered to help you, but it is vital that you know and understand all the risks involved.