Multiple Sclerosis (cont.)
How are the manifestations of multiple sclerosis treated?
There are numerous medications that are used to manage complications
associated with multiple sclerosis. The following table lists common complications,
examples of drug and non-drug therapy, and comments about
complications and/or management.
Table. Multiple sclerosis complications with examples of drug and non-drug management (this list is not exhaustive; some of the drugs listed below are used to treat
multiple sclerosis symptoms even though they have not been FDA-approved for this particular purpose)
Complication
|
Drugs
|
Non-drug management and
comments
|
Muscle spasticity
|
baclofen (Lioresal)
tizanidine (Zanaflex)
diazepam (Valium)
clonazepam (Klonopin)
dantrolene (Dantrium)
|
Physical therapy may also provide benefit. Most drugs are given by mouth. Some
drugs are given via spinal pumps. |
Weakness
|
None
|
Physical therapy and exercise mostly are used. Foot braces, canes or walkers are
of benefit.
|
Eye problems (acute optic neuritis)
|
methylprednisolone (Solu-Medrol)
|
Solu-Medrol is given during the acute attack intravenously, sometimes followed
by a corticosteroid by mouth.
|
Fatigue, emotional outbursts
|
Anti-depressants
amantadine (Symmetrel) for
fatigue;
modafinil (Provigil) for fatigue
|
Decrease or avoid physical activity and heat
exposure. Amitriptyline is
used for sudden laughing/weeping.
|
Pain
|
aspirin
Ibuprofen
acetaminophen
anti-convulsants
anti-depressants
|
Aspirin, NSAIDs, acetaminophen, or physical therapy are used for muscle and
back
pain. Anti-convulsants, like carbamazepine
(Tegretol) or gabapentin (Neurontin) are used
for face or limb pain. Anti-depressants or electrical stimulation are used for
prickling pain, intense tingling, and burning. Referral to pain specialist is
recommended with severe pain. |
Bladder dysfunction
|
Antibiotics
Vitamin C
oxybutynin (Ditropan)
|
Antibiotics are used to manage infections.
Vitamin C and cranberry juice
are used to prevent infections.
Catheters are used to relieve urine retention.
Oxybutynin (Ditropan,
Ditropan LX, Oxytrol) or tolterodine
(Detrol, Detrol LA)is used for bladder spasms.
|
Constipation
|
|
Increase fluids and fiber.
|
Sexual dysfunction
|
sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra),
papaverine (Pavabid, Vasal)
Vaginal gels
|
For males, erectile dysfunction drugs, papaverine, penile implant, or
electrostimulation are used.
For females, vaginal gels or a vibrating
device are used.
|
Tremors
|
|
Often resistant to treatment. Sometimes drugs,
or surgery are used if extreme.
|
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