A to Z of MS
Click on the relevant link for more information on a topic.
A to Z of MS Drugs and treatments used in the management of MS
In the treatment of MS symptoms, medication is usually just part of the approach and is often accompanied by other ways of managing the effects. Please consult with your neurologist, MS nurse or GP. This is not a complete list of treatments that may be used to treat MS.
The management of MS falls into three broad categories
- Drugs to treat relapses
- Drugs which modify the disease course
- Drugs and treatments used in the management of MS symptoms
Drugs to treat relapses
Corticosteroids (or steroids) are sometimes given for a few days, either in the form of tablets or by a drip into a vein. While there is no evidence that steroids make any difference to the long-term course of the disease, they can be effective at speeding up recovery from relapse.
Drugs which modify the disease course
Relapsing MS
There are three drugs called beta interferons and another disease modifying drug called glatiramer acetate, which can be prescribed for people with certain types of MS under the Department of Health's Risk-sharing Scheme.
Product names are shown in brackets.
- beta interferon 1a (Avonex)
- beta interferon 1a (Rebif)
- beta interferon 1b (Betaferon)
- glatiramer acetate (Copaxone)
Since the launch of the Risk-sharing Scheme in 2002, further disease modifying drugs have been licensed.
- natalizumab (Tysabri) - licensed in 2006, this drug is approved for people with rapidly evolving severe relapsing remitting multiple sclerosis but is not part of the Risk-sharing Scheme
- beta interferon 1b (Extavia) - licensed in 2009, this beta interferon drug is not explicitly part of the Risk-sharing Scheme
- fingolimod (Gilenya) - licensed in March 2011 for people with rapidly evolving severe relapsing remitting MS (two or more relapses a year), and as a second line treatment for people whose MS remains active despite treatment with one of the beta interferon drugs.
Read more in the book Disease modifying drug therapies
- Webcast on drug therapy
- Neurologist Prof David Bates addresses some of the questions people ask about disease modifying drugs
- Watch the webcast
MS Decisions is an independent website to help people considering starting treatment with one of the disease modifying drugs
Several other drugs are still in development and going through trials. For more information, see the Treatments in development pages.
Other drugs that have been used to modify the disease course in MS
The following are used less frequently in treating MS and will usually only be considered if other approaches are not successful.
- azathioprine (Imuran)
- alemtuzumab (Lemtrada)
- cyclophosphamide (Endoxana)
- intravenous immunoglobulin (IVIg)
- methotrexate (Maxtrex)
- mitoxantrone (Novantrone)
Progressive MS
The disease modifying drugs currently available all work by reducing the relapse rate. As a result, they have only been found to be effective for people with relapsing remitting MS and for some people with secondary progressive MS. The disease process in people with progressive MS is different and these drugs have not been found to be useful. As yet, no equivalent medication has been found for progressive MS, treatment of which is thus based on the management of symptoms.
Drugs and treatments used in the management of MS symptoms
The majority of treatment involves managing specific symptoms such as bladder problems or fatigue. Depending on the symptom, drug therapy might be part of the treatment along with input from therapists and/or the development of management strategies. There is more information on the range of treatment options in the sections on specific symptoms.
The following list includes some of the more common drugs and treatments and the symptoms for which they can be used. Product names are shown in brackets.
Balance problems
Bladder problems
- botulinum toxin (Botox)
- catheters
- desmopressin (Desmospray, Desmotabs)
- oxybutynin (Ditropan, Lyrinel)
- tolterodine (Detrusitol)
Cognition and cognitive symptoms
- Management often involves finding strategies to minimise the effects of symptoms - for more information, see the StayingSmart website
Depression
- amitriptyline (Triptafen)
- cognitive behavioural therapy (CBT)
- fluoxetine (Prozac)
- imipramine (Tofranil)
- paroxetine (Seroxat)
Erectile dysfunction
- alprostadil (Caverject, MUSE, Viridal Duo)
- sildenafil citrate (Viagra)
- tadalafil (Cialis)
- vardenafil (Levitra)
Fatigue
- amantadine (Lysovir, Symmetrel)
- cognitive behavioural therapy (CBT)
- exercise
- modafinil (Provigil)
- occupational therapy
- physiotherapy
Foot drop
Optic neuritis
Pain
- amitriptyline (Triptafen)
- carbamazepine (Tegretol)
- gabapentin (Neurontin)
- ibuprofen (several brand names) - musculoskeletal pain
- imipramine (Tofranil)
- lamotrigine (Lamictal)
- phenytoin (Epanutim)
- pregabalin (Lyrica)
- transcutaneous electrical nerve stimulation (TENS)
Problems with walking
- exercise
- fampridine (Fampyra)
- functional electrical stimulation (FES)
- hippotherapy (therapeutic horse riding)
- physiotherapy
Spasticity and spasms
- baclofen (Lioresal)
- botulinum toxin (Botox)
- carbamazepine (Tegretol)
- clonazepam (Rivotril)
- dantrolene (Dantrium)
- diazepam (Valium)
- exercise
- gabapentin (Neurontin)
- hippotherapy (therapeutic horse riding)
- phenol
- physiotherapy
- Sativex
- tizanidine (Zanaflex)
- transcutaneous electrical nerve stimulation (TENS)
Speech problems
Swallowing problems
Tremor
- clonazepam (Rivotril)
- deep brain stimulation
- thalamotomy
Trigeminal neuralgia
- carbamazepine (Tegretol)
- gabapentin (Neurontin)
- oxcarbazepine (Trileptal)
- phenytoin (Epanutim)
- pregabalin (Lyrica)
