While there is no cure for MS, there are a number of treatment options, and some MS patients do not need therapy at all. Treatments for MS generally can be categorized as treatments for attacks, strategies to modify the course of MS and strategies to treat symptoms.
To treat attacks, corticosteroids are often used to reduce the inflammation associated with relapses. Corticosteroids are also used to prolong the onset of MS when used early in its course, and can be used to treat visual symptoms of MS and acute worsening in patients already diagnosed with MS. In addition, plasma exchange, a procedure to remove some blood from the body and mix blood cells with a replacement solution that is then returned to the body, can help people with severe MS who do not respond to corticosteroids cope with symptoms.
Beta interferons are used to slow the progress of MS, as these drugs seem to reduce the number of lessen the severity of attacks. These drugs have serious side effects, including potential liver damage. A medication called glatiramer acetate can also reduce the number of MS attacks; it is thought to work by blocking the immune system’s attack on myelin. An oral medication called fingolimod traps immune cells in lymph nodes, which may reduce MS attacks and short-term disability. Individuals who take this medication will need to be immune to the chickenpox virus. Another medication, natalizumab, can reduce the number of MS attacks by interfering with the movement of potentially damaging immune cells from the bloodstream to the brain and spinal cord. However, it increases the risk of a brain infection called PML, which is usually fatal. Mitoxandine, an immunosuppressant, is used for severe, advanced MS, though its complications include blood cancers and heart problems. Finally, a medication called teriflunomide can reduce attacks and lesions in MS patients, though it can cause serious liver damage.
Strategies to treat symptoms include physical therapy; an oral medication called dalfampridine, which can help improve walking speed in some MS patients; muscle relaxants, which can improve muscle spasticity; medications to treat fatigue; and other medications for depression, pain, or bladder or bowel control problems.