Although there is no prevention or cure for people with multiple sclerosis, there are a number of drugs available that slow down the progress of this disease. These medications are known as disease modifying drugs. Avonex, Betaseron, Copaxone, Novantrone and Rebif are some of the drugs approved by the FDA in the treatment of MS.
All these drugs work by altering or suppressing activity in the immune system. This is because in MS the body’s own immune system attacks the nerve cells, for reasons unknown to scientists. These drugs are not a cure; they reduce the frequency and severity of MS symptoms, and delay its progression.
All these drugs are known to improve the quality of life for people with multiple sclerosis, and for this reason most doctors suggest that they be started right away after diagnoses of relapsing-remitting MS is made. Relapsing-remitting MS as defined as the period in which symptoms of MS worsen, and are then followed by periods of full or partial recovery with no symptoms. These attacks can occur over several weeks and recovery from these attacks can take months for some, during this time however, MS does not worsen. This pattern of attacks is fairly common in most people suffering from MS.
The decision to implement drug therapy should be made after a thorough discussion with your doctor. You need to consider all the benefits and side effects before you take any of the above mentioned medications. The most important aim of this therapy should be to find a treatment that you can be most comfortable in.
Avonex, Betaseron & Rebif
These three drugs are known as interferon beta medications. Interferon's are a group of alpha, beta and gamma proteins in the immune system that act in different ways to control the immune system in the body. They also have antiviral properties. Scientists believe that interferon beta is very effective in treating MS.
Avonex is an FDA approved drug used in the treatment of relapsing MS. It not only reduces the progression of this disease, but also reduces the size of lesions in the brain and delays the frequency of exacerbations or attacks. It is an inter-muscular drug.
Betaseron also treats the relapsing form of MS, and reduces the number of MS attacks, their frequency, and severity. Additionally this FDA approved drug also stabilizes the size of brain lesions. It is given subcutaneously every other day.
Also used for treating relapsing MS, Rebif has been approved by the FDA and has proven effective in reducing brain lesions, frequency of relapses, and delaying some of the disabilities associated with MS.
As all these three drugs are Interferon betas, they have similar side effects which include; flu-like symptoms, including chills, fatigue, muscle aches and sweating, reactions at the site of the injection like redness, swelling and pain and these drugs can also cause depressive symptoms like sadness, anxiety, irritability, guilt, poor concentration, sleeplessness, lack of appetite and confusion. If the latter side effects occur, it is imperative that you speak to your doctor immediately.
Pregnant women and women tying to get pregnant, along with people suffering from depression and who have liver function problems need to take special precautions when using any of these three medications. Interferon drugs can also affect blood cells and thyroid functioning as well.
Copaxone
Copaxone is an artificial protein that resembles a protein that is part of the myelin. It works by altering the activity of the immune system. Copaxone is used to treat the relapsing-remitting form of MS, and is administered subcutaneously, once a day. It only reduces the frequency of attacks, it bodes not reduce or delay disability.
Side effects of Copaxone include; nausea; weakness; redness, pain and swelling at the injection site, and chest pain or tightness. This feeling of chest tightness lasts only a few minutes and then goes away.
Pregnant women, women trying to get pregnant and breast-feeding women should not use this medication.
Novantrone
Novantrone is another immunosuppressive drug that slows disability and reduces the rate of relapse in people with relapsing-remitting MS. It also reduces the formation of new lesions in the brain.
Novantrone is administered intravenously via a drip, and treatment takes place after every three months. Before treatment commences however, tests need to be conducted to determine your overall health, especially your blood cell count, and an EKG and an echocardiogram to detect the strength of your heart. This treatment lasts two hours, during which time you are given Novantrone, IV Solu-Medrol (steroid medicine), Zofran (an anti-nausea drug), and IV fluids through an IV drip. As Novantrone suppresses your immune system, you will have an increased risk of infection after treatment. It's important to avoid contact with people who are sick.
Side effects from Novantrone include; a blue-green color of urine for 24-hours after receiving Novantrone, a temporary bluish color of the whites of the eyes, mild or moderate nausea, flu-like symptoms, stomach pain or discomfort, sore mouth, headaches, diarrhea, pain, swelling, redness, or irritation at the injection site, unusual bleeding or bruising, chest pain or discomfort, difficulty breathing, wheezing, an irregular heartbeat, swollen feet or ankles and mild to moderate hair loss. However, if you experience; fever and flu-like symptoms, shortness of breath, vomiting, diarrhea, rapid heartbeats or swollen feet, call your doctor immediately.
Treating MS With IV Steroids – Solu-Medrol
Solu-Medrol is a powerful steroid that eases inflammation and treats acute attacks of MS. During an acute attack of multiple sclerosis, there is a distinct increase in the severity of symptoms. New symptoms may appear, or your existing symptoms worsen. An attack of this sort usually comes with inflammation.
Steroid treatment is recommended if the symptoms are severe. When an acute attack occurs you receive Solu-Medrol at a treatment center each day for one to five days, depending on your treatment plan. Not everyone experiences side effects from this treatment, but the most common are: stomach irritation, increased energy, rapid heartbeat, facial flushing, feeling warm or cold, fluid retention, mood changes, insomnia and nausea. Some long-term side effects of steroids include: osteoporosis, stomach ulcers, cataracts, weight gain, acne and diabetes.
Cytoxan Therapy
Cytoxan therapy works by suppressing the immune system. It slows down MS by keeping white blood cells from attacking the central nervous system. It is administered intravenously by drip. Unfortunately, Cytoxan has serious side effects, which you need to be aware of before you try this therapy. Its side effects include: nausea, hair thinning/loss and a low white blood cell count. To control nausea associated with Cytoxan therapy, you will be given either Zofran or Reglan. During treatment, you will be given a combination of Cytoxan, Solu-Medrol, Zofran and/or Reglan, and IV fluid via a drip. As Cytoxan suppresses your immune system, you will be prone to infections after treatment. And will need to avoid contact with people who are sick, especially the first 12-14 days.
Imuran Therapy
Imuran is another immunosuppressant that can be used to slow the progression of MS in people who are not responding well to other treatments. It may also be used with other disease-modifying therapies, such as Avonex, to boost its effect. It is an oral medication, taken twice a day. It is important that you take this medication regularly as prescribed; and do not stop taking it unless advised by your doctor. Possible side effects from Imuran include; increased stomach irritation, vomiting, changes in hair color and texture along with hair loss, loss of appetite, blood in the urine or stool, unusual bruising, fatigue and development of mouth sores and ulcers. And like other immunosuppressant's, it increases your risk for infection, so it is important to take care of yourself. If you contract an infection its is important to see your doctor right away.
Intrathecal Baclofen Pump Therapy
Baclofen is a medication commonly used to decrease muscle spasticity related to multiple sclerosis, spinal cord injuries and other neurological diseases. Spasticity is defined by tightness or stiffness of muscles that interfere with voluntary muscle movement. Baclofen works by restoring and reducing muscle hyperactivity, allowing for more normal muscle movements. Side effects from Baclofen include: dizziness, drowsiness, headaches, nausea and weakness. The intrathecal Baclofen pump therapy is the way doctors give this drug directly into the spinal fluid. The system is surgically placed under the skin of the abdomen near the waistline, and releases prescribed amounts of medicine through a catheter.
Anyone who has spasticity that is not responsive to oral treatment is a candidate for this therapy. The advantage of this therapy is that it efficiently reduces spasticity and involuntary spasms, promoting a more active lifestyle, better sleep, and reduces need for oral medications. The disadvantage is that there are certain risks that must be considered with any surgery. The risks include: an adverse reaction to anesthesia, infection, bleeding and bladder control can be altered. Pump malfunctions can also occur.
Deep Brain Stimulation
Deep brain stimulation (DBS) is used to treat tremors in people with multiple sclerosis, and Parkinson's disease. In DBS, the doctor inactivates the thalamus or globus pallidus parts of the brain, by placing the tip of an electrode in the thalamus or in the globus pallidus. Deep brain stimulation offers many advantages, but it does not cure MS. It is only able to relieve the symptoms of tremors in MS.
Treating Multiple Sclerosis With Botox
Botulinum toxin or botox (for short) is a muscle relaxing medication used to decrease spasticity related to multiple sclerosis. Botulinum toxin is derived from Clostridium Botulinum, a bacterium and is in a class of drugs called neurotoxins. Despite the drug's effectiveness, the FDA has yet to approve the use of botox to treat MS-related spasticity.
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