Multiple Sclerosis - Treatment
Treatment of MS takes two forms. First, although there are no drugs that will actually cure the disease, there are drugs that can slow down the course of MS. Second, a variety of treatments can be used to ease the symptoms of multiple sclerosis.
As of 1997, three drugs had been approved for use with multiple sclerosis: Avonex, Betaseron, and Copaxone. All three reduce the rate of relapses in the relapsing-remitting form of MS. Each has other benefits as well. Avonex may slow the progress of physical damage; Betaseron may reduce the severity of symptoms; and Copaxone may decrease disability. All three drugs are administered by injection.
Immunosuppressant drugs have also been used to treat severe relapses. These drugs act on the immune system directly, causing it to work less effectively. The drugs carry some risks, so a patient may have to be hospitalized during treatment.
MS causes a large variety of symptoms. For that reason, many different treatments may be necessary to relieve those symptoms. A person should be vaccinated against influenza (see influenza entry). The vaccination can help protect against respiratory (breathing) problems, thus reducing the symptoms of MS. Preventing complications from MS is also important. Such complications include pneumonia (see pneumonia entry), bed sores, injuries from falls, or urinary infections. These complications lead to death more often than does MS.
Physical therapy is important in treating MS. It helps the patient strengthen and retrain affected muscles, maintain range of motion to prevent muscle stiffening, learn to use assistive devices such as canes and walkers, and learn safer and more energy-efficient ways of moving and sitting.
A program of physical therapy usually includes exercise and stretching. These activities can be taught and practiced at home. Swimming is often recommended. It provides a way for a patient to get exercise without becoming overheated.
Treatment programs usually include occupational therapy as well. People with MS are taught how to deal with daily activities, such as dressing, feeding, and washing. The occupational therapist can make suggestions for arranging the home and work environment so that an MS patient can function more safely and efficiently.
An MS patient may need training in bowel and bladder control. Drugs are sometimes used to deal with these problems. They help the patient to empty his or her bowel and bladder on a more normal schedule.
Spasticity can be treated with drugs as well. Baclofen (pronounced BAK-lo-fen) and diazepam (pronounced di-AZE-uh-pam, trade name Valium) are given by mouth, while botulin toxin (Botox) is given by injection. These drugs can help relieve the pain caused by spasticity. Back pain can be treated with over-the-counter pain relievers, such as aspirin or acetaminophen (pronounced uh-see-tuh-MIN-uh-fuhn, trade name Tylenol), or with physical therapy.
Fatigue can be treated by having the patient plan and follow a regular daily routine. The routine should allow for frequent rest periods. Drugs such as amantadine (pronounced uh-MANT-uh-deen, trade name Symmetrel) and pemoline (pronounced PEM-uh-leen, trade name Cylert) can help improve alertness and lessen fatigue. Corticosteroids are used to treat visual problems. Other types of drugs can be used to treat seizures, vertigo, and tremor.
A variety of alternative treatments have been recommended for multiple sclerosis. So far, there are few scientific data to support most of these claims. For example, bee venom has been suggested as a treatment for MS. But studies have not supported this claim. Marijuana has been recommended for the relief of certain symptoms of MS, including tremor, pain, and spasticity. But the drug has side effects of its own. It is not widely recommended in the United States for the treatment of MS.
Some practitioners suggest that high doses of vitamins, minerals, and other dietary supplements can help slow the progress of MS. Specific nutrients recommended include linoleic (pronounced lin-uh-LEE-ik) acids, selenium, vitamin E, and a diet low in saturated fats.