Drug Treatments

There are disease modifying drugs & drugs that treat the symptoms of MS.

Disease modifying drugs affect the long-term course of MS and symptomatic treatments treat a particular symptom.

Disease Modifying Drugs (DMDs)

There are currently four Disease Modifying Drugs (DMDs) which can reduce the frequency and severity of clinical relapses. A relapse can be defined as periodic attacks of MS symptoms followed by full or partial recovery. In some cases complete recovery may occur from all symptoms but in most cases recovery is partial. Relapses may recur every few months or may be as much as years apart.

DMDs are available on the NHS under the “Risk Sharing” scheme to those who meet criteria set out by the Association of British Neurologists and are said to reduce relapse rate by approximately one third.

DMDs available are as follows:-

Beta Interferon drugs – Avonex, Betaferon and Rebif may be prescribed for the treatment of relapsing/remitting MS and Betaferon can also be used for secondary progressive MS if relapses are still occurring.

Avonex (Biogen) - a weekly injection into the muscle.

Betaferon (Schering) – an injection every other day subcutaneously (under the skin).

Rebif (Serono) – an injection three times a week subcutaneously (under the skin).

Copaxone is a synthetic polypeptide consisting of a mixture of 4 amino acids and is a daily injection subcutaneously (under the skin).

Fingolimod (Gilenya) is a newly approved disease modifying drug with is taken orally.

For more detailed information about DMD’s, please see our Choices leaflet ‘Disease Modifying Drugs’

Tysabri (Natalizumab)

A monoclonal antibody that works in a different way to the above DMDs, by preventing immune cells leaving the blood stream and entering areas of inflammation.

Available for people on the NHS with rapidly evolving, severe relapsing remitting MS. Rapidly evolving, severe RRMS is defined by two or more disabling relapses in one year along with an increase of lesions on an MRI.

Tysabri is a once a month intravenous infusion into a vein over a one hour period in a registered infusion facility.

For more detailed information about Tysabri. Please see our Choices leaflet ‘Tysabri’

Sativex

Sativex is a cannabis based medicine for MS-related spasticity when people have been unable to find relief with other treatments or have found side effects of other drugs too difficult to cope with.

Sativex is an oral-mucosal spray into the mouth, under the tongue or inside of the cheeks. The number of sprays or timings of these sprays varies dependent on severity of symptoms and will be confirmed by the prescribing doctor. The maximum number of sprays a day is 12 and a gap of at least 15 minutes should be left between sprays.

The most common side effects are dizziness, fatigue, drowsiness and nausea.

Low Dose Naltrexone (LDN)

LDN has been used in the treatment of MS in the USA since 1985 but it is relatively new in the United Kingdom.

Naltrexone is a drug referred to as an opiate antagonist. Its normal use is to treat opiate drug addicts addicted to drugs such as heroin; however when taken to treat MS, the dose is much smaller. Those taking it have experienced a range of benefits, including reduced spasm and fatigue, improvements in bladder control, heat tolerance, mobility, sleep, pain, tremor and other symptoms. The two main symptoms that appear to improve most significantly are muscle spasm and fatigue.

For more information about LDN, please see our Choices leaflet 'Low Dose Naltrexone'.

Other Drugs used in MS

Methotrexate – An immunosuppressant drug usually used for treating arthritis and psoriasis. It is sometimes used in a low dose as a treatment for progressive MS. It is taken orally.

Mitoxantrone (Novantrone) – Licensed in the UK as a form of chemotherapy used in cancer treatment and can be used to treat some forms of MS. Usually given to people who have not responded to Copaxone or any of the Interferons. It is given at the Neurologists discretion by intravenous infusion.

Steroids - Steroids are sometimes used when a person experiences a relapse to help speed recovery.

Steroids can reduce inflammation in the CNS. They are usually administered intravenously but sometimes orally. In short term use, side effects are usually minor. Long term use should be avoided as this can cause many side effects including weight gain, acne and cataracts.

For this reason, NICE guidelines recommend only using steroids three times a year.

Drugs in development and trial

• Alemtuzumab (Campath 1H)
• BG0012
• Laquinimod
• Trimesta (Oral Estriol)
• Tovaxin
• Ampyra (Fampyra)
• Teriflunomide
• Rituximab

For more information on drugs under going research for use in MS  please visit the MS Drugs Research pages.

Drugs used to manage symptoms

Spasticity

• Baclofen
• Dantrolene
• Diazepam
• Botox
• Tizanidine (zanaflex)
• Sativex
• Gabapentin

Bladder Dysfunction

• Oxybutynin
• Desmopressin
• Detrusitol (Tolterodine)
• Botox

Fatigue

• Amantadine
• Modafinil

Tremor

• Propranolol
• Primidone
• Clonazepam
• Clonidine

Pain

• Gabapentin
• Pregabalin
• Carbamazepine
• Amitriptyline

Erectile Dysfunction

• Cialis
• Viagra
• Levitra

© Multiple Sclerosis Resource Centre