Which ms treatment is best

Injections may involve a needle or an injection pen. The side effects of most injectable medications are unpleasant but usually short-lived and manageable.

You may experience pain, swelling, or skin reactions at the injection site. Many of these medications may cause flu-like symptoms as well as liver test abnormalities. Daclizumab Zinbryta is an injectable medication that had previously been used to treat MS. Its manufacturers voluntarily removed it from the global market in due to concerns about safety, including reports of severe liver damage and anaphylaxis.

Infusion medications are given intravenously in a clinical setting. Common side effects include nausea, headache, and abdominal discomfort. In rare cases, these medications may cause serious side effects such as infection and heart damage. Neuropathic pain is caused by damage to your nerves, and is usually sharp and stabbing. It can also occur in the form of extreme skin sensitivity or a burning sensation. This type of pain can be treated using the medicines gabapentin or carbamazepine, or with a medicine called amitriptyline.

This is an older type of antidepressant , but these days it's mainly used for pain control. Living with MS can cause stresses and strains to the muscles and joints in your body.

A physiotherapist may be able to help with this pain by suggesting exercise techniques or better seating positions. Alternatively, you may have a device that stimulates your nerves called a transcutaneous electrical nerve stimulation TENS machine.

If you experience problems with thinking and memory, any treatment you receive will be fully explained and recorded so it's clear to you. You should be referred to a clinical psychologist, who will assess your problems and suggest ways to manage them. If you experience emotional outbursts, such as laughing or crying for no apparent reason, you should be assessed by a specialist like a clinical psychologist.

If you often feel anxious or worried, you may be prescribed antidepressants or benzodiazepines, which are a type of tranquilliser that have a calming effect. Men with MS who find it hard to obtain or maintain an erection erectile dysfunction may be prescribed medicine to temporarily increase the blood flow to the penis, such as sildenafil Viagra. Relationship counselling or seeing a sex therapist may also help both men and women with MS who are having problems with reduced interest in sex or difficulty reaching orgasm.

Various medicines are available if you have an overactive bladder or need to pee frequently during the night. If you find it difficult to empty your bladder, advice from a continence nurse or physiotherapist can help.

Handheld external stimulators can also help some people start peeing or empty the bladder. Occasionally, a catheter can be used to empty the bladder when needed. In rare cases, people with MS may need a long-term catheter to keep the bladder emptying safely. You may be referred to a continence adviser or urologist, who can offer specialist treatment and advice, such as botulinim toxin injections, bladder exercises or electrical treatment for your bladder muscles.

Beyond these studies, the most objective guide of effectiveness and safety comes from a meta-analysis published in by the independent group the Cochrane Collaboration, says Lauren B. The group ranked the drugs' relative efficacy for reducing relapses and decreasing the probability of worsening neurologic impairment, says Dr. These four head the list.

Effectiveness: At or near the top when it comes to efficacy. Krupp says. Dosage: 12 mg per day on five consecutive days, followed by 12 mg per day on three consecutive days one year later, as a supervised intravenous infusion. Side effects: A possible increased risk of several types of cancer, including thyroid, melanoma, and blood cancers. It can also cause serious and sometimes fatal autoimmune reactions, including bleeding conditions and kidney complications, and dangerous infusion reactions while the medication is being given.

You and your neurologist may consider alemtuzumab only after a serious review of the risks involved and after at least two other MS drugs have failed and your disease is progressing significantly.

Effectiveness: "Natalizumab may not be quite as effective as alemtuzumab, but it is still highly effective and does not have the same extreme risks," Dr. How it works : Prevents white blood cells of the immune system from entering the brain and spinal cord. Side effects: A certain percentage of people who take natalizumab will develop a rare, often fatal brain infection called progressive multifocal leukoencephalopathy PML. Signs of PML include impaired mental functioning, vision loss, speech disturbances, and clumsiness and lack of coordination.

About 20 percent of people who develop PML will die, and those who survive usually are significantly disabled. The infection is caused by the John Cunningham JC virus, a common virus to which about half of all people have been exposed. If you have not been exposed to the virus, your risk of PML is extremely low. Otherwise, your risk is higher. If you've also taken other immunosuppressant drugs in the past and have taken natalizumab for two years or more, your risk could be as high as one in Effectiveness: Fingolimod comes next in the Cochrane group's ranking, and appears to both reduce exacerbations and slow the progression of the disease.

In studies presented at the Annual Meeting of the American Academy of Neurology AAN , patients taking fingolimod had a slower rate of loss of brain volume than those on either placebo or interferon over the course of as many as seven to eight years. How it works: Traps some white blood cells in the lymph nodes, so they aren't released into the bloodstream, where they can attack the nervous system.

Side effects: Known risk of PML, although lower than with natalizumab. So far, nine of the approximately , people who have taken fingolimod have developed PML, says Dr. It can also cause a temporary slowing of the heart rate after the first dose, which requires extra monitoring. There is also a risk of macular edema fluid and protein deposits that cause swelling in the eye and fungal infections.

Effectiveness: Ocrelizumab was not included in the Cochrane analysis because it has yet to receive approval from the FDA, but Dr. MS relapses are caused by inflammation in the central nervous system that damages the myelin coating around nerve fibers. This damage slows or disrupts the transmission of nerve impulses and causes the symptoms of MS.

Read more about managing relapses here. Below are common symptoms of MS and some of the medications used to treat those symptoms. Learn More. Download Brochure. Our MS Navigators help identify solutions and provide access to the resources you are looking for.

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