If youve been diagnosed withmultiple sclerosis(MS), its time to start exploring treatment options.
There is no cure forMSyetbut youcanlive well with this disease.
Disease-Modifying Therapies
DMTs are an importantfirst step to treating your MS.
Verywell / Nusha Ashjaee
While they wont directly help your symptoms, they work behind the scenes to slow down your condition.
The earlier you start, the better chance you have of reducing your symptom load and preserving your function.
DMTs come in three different forms: injections, oral therapies, andIV infusions.
These are older therapies.
Beta Interferon Drugs
Interferons are proteins that your immune system creates to get to combat a viral infection.
In addition, some people experience flu-like symptoms, but that usually stops happening as treatment continues.
Copaxone, Glatopa
Also in the injectable category are Copaxone and Glatopa (glatiramer acetate).
Rotating injection sites and using a warm compress prior to injecting can help minimize the reaction.
Ocrevus Zunovo is a subcutaneous injection given every 6 months.
An Ocerevus infusion is an alternative.
GilenyaandTascenso ODT(fingolimod) are pills that you take once a day.
Mayzent(siponimod) andZeposia(ozanimod) are newer DMTs that work similarly to Gilenya.
They are both tablets taken once a day.
Common side effects of Mayzent include headache and high blood pressure.
Tecfidera(dimethyl fumarate) is a pill thats taken twice daily.
It activates a response in your body thats designed to protect cells that are in distress.
Exactly how this works in someone with MS is unclear.
Common side effects of Tecfidera are flushing, nausea, diarrhea, and stomach pain.
Vumerity(diroximel fumarate) is an oral capsule taken twice a day.
People appear to tolerate Vumerity better than Tecfidera, especially when it comes to gastrointestinal side effects.
Bafiertam(monomethyl fumarate) is another oral DMT that is similar to Tecfidera and Vumerity.
It is also taken twice per day and has similar side effects, most commonly flushing and nausea.
It may also cause headaches, hair thinning, diarrhea, nausea, or abnormal liver blood tests.
Aubagio is also contraindicated for pregnancy.
Mavenclad(cladribine) is for highly active relapsing forms of MS.
The dosage schedule is unusual, with short periods of taking pills spread out over two years.
It may also lower your bodys resistance to infections and cancer.
People with kidney problems and those who are pregnant or breastfeeding shouldnt take Mavenclad.
These DMTs are typically for more severe cases, and they can come with severe side effects.
Drugs for Treating Fatigue
Fatigue is among the most pervasive and ubiquitous symptoms of MS. Nerve pain requires drugs that target overactivity in the nervous system.
Muscle relaxants like Fleqsuvy and Ozobax (baclofen) may help.
Moderate exercise, designed by aphysical therapistand geared to your fitness level, can help as well.
Lifestyle
Lifestyle changesmay play a larger role in managing MS than you realize.
While theyre certainly no replacement for DMTs or other medications, they can have a big impact.
Diet
Finding the diet that best alleviates your symptoms takes experimentation.
Whats true of all the diets is that their effectiveness varies greatly from person to person.
Consult with your healthcare provider to double-check any dietary changes you want to make are okay for you.
Two dietary supplementsvitamin D and probioticshave some evidence asMS treatments.
Your healthcare provider or a nutritionist can help you determine appropriate dosages for you.
Healthy Sleep Habits
A vast majority of people with MS experience some kind ofsleep disturbance.
Often, its MS symptoms that keep you from sleeping well.
The disease can also directly contribute to sleep disorders such as sleep apnea, insomnia, and narcolepsy.
Poor sleep may also be a side effect of medications.
This includes:
Asleep logmay help you spot problems you would otherwise miss.
If you struggle with establishing better habits, you may also benefit fromcognitive behavioral therapy.
The Nap Conundrum
Sleep experts say napping can lead to tossing and turning at night.
Many people with MS also explore mind-body therapies.
Popular mind-body approaches include progressive muscle relaxation therapy, yoga, and mindfulness meditation.
Experimental Treatments
As researchers learn more about MS, different types of therapies are emerging.
More medications similar to Tysabri, called monoclonal antibodies, are currently being explored.
Estriol
Estriol is a throw in of estrogen thats only produced in pregnancy.
Its the suspected reason that the risk of relapse drops by 70% in the third trimester of pregnancy.
Research on estriol for treating MS is moving forward and, so far, results are promising.
Thats all really promising, but theres a downside.
For the process to work, the immune system has to be either wiped out or suppressed.
In theLancetstudy, it was fully wiped out.
Because of that, one participant died of infection.
Another developed severe liver-related problems and was hospitalized for an extended time.
Others experienced side effects such asneutropenic feverand chemotherapy-related toxicities.
In a 2015 study published inJAMA, participants immune systems were suppressed rather than obliterated.
Results were similar to theLancetstudy but with significantly fewer worrisome side effects, and no deaths or serious infections.
2017;7(12):78. doi:10.3390/brainsci7070078
National Multiple Sclerosis Society.Disease modification.
2019;7(3):49. doi:10.3390/biomedicines7030049
National Library of Medicine:DailyMed.
Copaxoneglatiramer acetate injection, solution[drug label].
National Library of Medicine: DailyMed.Gilenyafingolimod hcl capsule[drug label].
National Library of Medicine: DailyMed.Tascenso ODTfingolimod lauryl sulfate tablet, orally disintegrating[drug label].
National Library of Medicine: DailyMed.Mayzentsiponimod tablet, film coated[drug label].
National Library of Medicine: DailyMed.Zeposiaozanimod hydrochloride capsule[drug label].
National Library of Medicine: DailyMed.Tecfideradimethyl fumarate kit[drug label].
National Library of Medicine: DailyMed.Vumeritydiroximel fumarate capsule[drug label].
National Library of Medicine: DailyMed.Bafiertammonomethyl fumarate capsule [drug label].
National Library of Medicine: DailyMed.Aubagioteriflunomide tablet, film coated[drug label].
National Library of Medicine: DailyMed.Mavencladcladribine[drug label].
National Library of Medicine: DailyMed.Briumviublituximab injection, solution, concentrate[drug label].
National Library of Medicine: DailyMed.Lemtradaalemtuzumab injection, solution, concentrate[drug label].
National Library of Medicine: DailyMed.Mitoxantrone injection, solution, concentrate[drug label].
National Library of Medicine: DailyMed.Tysabrinatalizumab injection[drug label].
Food and Drug Administration.FDA approves first biosimilar to treat multiple sclerosis.
The Multiple Sclerosis Association of America.Long-term treatments for multiple sclerosis.
National Library of Medicine: DailyMed.Ocrevusocrelizumab injection[drug label].
Multiple Sclerosis Association of America.Fatigue.
Giesser B.Exercise in the management of persons with multiple sclerosis.Ther Adv Neurol Disord.
2015;8(3):123-130. doi:10.1177/1756285615576663
Multiple Sclerosis Association of America.Wellness tips.
Voskuhl R, Momtazee C.Pregnancy: effect on multiple sclerosis, treatment considerations, and breastfeeding.Neurotherapeutics.
2015;313(3):275-84. doi:10.1001/jama.2014.17986
