|
|
Multiple SclerosisPage 10
Are Any MS Symptoms Treatable?
While some scientists look for therapies that will affect the overall course of the disease, others are searching for new and better medications to control the symptoms of MS without triggering intolerable side effects.
Many people with MS have problems with spasticity, a condition that primarily affects the lower limbs. Spasticity can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, especially at night. It is usually treated with muscle relaxants and tranquilizers.
- Baclofen (Lioresal), the most commonly prescribed medication for this symptom, may be taken orally or, in severe cases, injected into the spinal cord.
- Tizanidine (Zanaflex), used for years in Europe and now approved in the United States, appears to function similarly to Baclofen.
- Diazepam (Valium), Clonazepam (Klonopin), and Dantrolene (Dantrium) can also reduce spasticity.
Although its beneficial effect is temporary, physical therapy may also be useful and can help prevent the irreversible shortening of muscles known as contractures. Surgery to reduce spasticity is rarely appropriate in MS.
Weakness and ataxia (incoordination) are also characteristic of MS. When weakness is a problem, some spasticity can actually be beneficial by lending support to weak limbs. In such cases, medication levels that alleviate spasticity completely may be inappropriate. Physical therapy and exercise can also help preserve remaining function, and patients may find that various aids-such as foot braces, canes, and walkers-can help them remain independent and mobile. Occasionally, physicians can provide temporary relief from weakness, spasms, and pain by injecting a drug called phenol into the spinal cord, muscles, or nerves in the arms or legs. Further research is needed to find or develop effective treatments for MS-related weakness and ataxia.
Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used. A trial of oral prednisone in patients with visual problems suggests that this steroid is not only ineffective in speeding recovery but may also increase patients' risk for future MS attacks. Curiously, prednisone injected directly into the veins - at ten times the oral dose - did seem to produce short term recovery. Because of the link between optic neuritis and MS, the study's investigators believe these findings may hold true for the treatment of MS as well. A follow up study of optic neuritis patients will address this and other questions.
Fatigue, especially in the legs, is a common symptom of MS and may be both physical and psychological. Avoiding excessive activity and heat are probably the most important measures patients can take to counter physiological fatigue. If psychological aspects of fatigue such as depression or apathy (a lack of emotion or interest, without feeling) are evident, antidepressant medications may help. Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still - experimental drug aminopyridine.
People with MS may experience several types of pain. Muscle and back pain can be helped by aspirin or acetaminophen and physical therapy to correct faulty posture and strengthen and stretch muscles. The sharp, stabbing facial pain known as trigeminal neuralgia is commonly treated with carbamazapine or other anticonvulsant drugs or, occasionally, surgery. Intense tingling and burning sensations are harder to treat. Some people get relief with antidepressant drugs, others may respond to electrical stimulation of the nerves in the affected area. In some cases, the physician may recommend codeine.
As the disease progresses, some patients develop bladder malfunctions. Urinary problems are often the result of infections that can be treated with antibiotics. The physician may recommend that patients take vitamin C supplements or drink cranberry juice, as these measures acidify urine and may reduce the risk of further infections. Several medications are also available. The most common bladder problems encountered by MS patients are urinary frequency, urgency, or incontinence. A small number of patients, however, retain large amounts of urine. In these patients, catheterization may be necessary. In this procedure, a catheter or drainage tube is temporarily inserted (by the patient or a caretaker) into the urethra several times a day to drain urine from the bladder. Surgery may be indicated in severe, intractable cases. Scientists have developed a "bladder pacemaker" that has helped people with urinary incontinence in preliminary trials. The pacemaker, which is surgically implanted, is controlled by a hand held unit that allows the patient to electrically stimulate the nerves that control bladder function.
MS patients with urinary problems may be reluctant to drink enough fluids, leading to constipation. Drinking more water and adding fiber to the diet usually alleviates this condition. Sexual dysfunction may also occur, especially in patients with urinary problems. Men may experience occasional failure to attain an erection. Penile implants, injection of the drug papaverine, and electrostimulation are techniques used to resolve the problem. Women may experience insufficient lubrication or have difficulty reaching orgasm - in these cases, vaginal gels and vibrating devices may be helpful. Counseling is also beneficial, especially in the absence of urinary problems, since psychological factors can also cause these symptoms. For instance, depression can intensify symptoms of fatigue, pain, and sexual dysfunction. In addition to counseling, the physician may prescribe antidepressant or antianxiety medications. Amitriptyline is used to treat laughing / weeping syndrome.
Tremors are often resistant to therapy, but can sometimes be treated with drugs or, in extreme cases, surgery. Investigators are currently examining a number of experimental treatments for tremor.
Drugs Used to Treat Symptoms of Multiple Sclerosis
Spasticity
Drugs Used:
- Baclofen (Lioresal)
- Tizanidine (Zanaflex)
- Diazepam (Valium)
- Clonazepam (Klonopin)
- Dantrolene (Dantrium)
Optic Neuritis
Drugs Used:
- Methylprednisolone (Solu-Medrol)
- Oral steroids
Fatigue
Drugs Used:
- Antidepressants
- Amantadine (Symmetrel)
- Pemoline (Cylert)
Pain
Drugs Used:
- Aspirin or Acetaminophen
- Antidepressants
- Codeine
Trigeminal Neuralgia
Drugs Used:
- Carbamazapine, other Anticonvulsant
Sexual Dysfunction
Drugs Used:
- Papaverine injections(in men)
Page 1 What is Multiple Sclerosis?
Page 2 The Immune System
Page 3 Genetics
Page 4 What is the Course of MS?
Page 5 Symptoms of MS
Page 6 How is MS Diagnosed?
Page 7 Can MS be Treated?
Page 8 Immunotherapy
Page 9 Therapy
Page 10 Are Any MS Symptoms Treatable?
Page 11 Recent Advances Made in MS Research
References:
NIH Publication No. 96-75 - September 1996 - www.ninds.nih.gov/disorders/multiple_sclerosis/detail_multiple_sclerosis.htm
This summary is a general overview about the topic discussed and does not include all the facts, or include everything there is to know about any medicine and/or products mentioned. Do not use any medicine and/or products without first talking to your doctor. Possible side effects of medications, other than those listed, may occur. Other brand names or generic forms of this medicine may also be available. If you have questions or concerns, or want more information, your doctor or pharmacist has the complete prescribing information about this medicine and possible drug interactions. Full Disclaimer
|
Nexium - Esomeprazole
Aciphex - Rabeprazole
Prevacid - Lansoprazole
Prilosec - Omeprazole
Prilosec OCT
Protonix - Pantoprazole
| GastroEsophageal Reflux Disease
|
GERD
Causes of GERD
Diet for GERD
Infant GERD
Children 1 - 11 Years Old
Medication for GERD
Symptoms of GERD
GERD Surgery
GERD Treatment
Heartburn
Causes of Heartburn
Symptoms of Heartburn
Heartburn Medications
Heartburn Remedy
Can Flatulence Be Controlled
Lump In Throat
Proton Pump Inhibitors
Remedies for GERD
Acne
Hair Removal
HGH
|