Treatments and drugs

By Mayo Clinic Staff

There is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, slowing the progression of the disease and managing symptoms. Some people have such mild symptoms that no treatment is necessary.

Treatments for attacks

  • Corticosteroids, such as oral prednisone and intravenous methylprednisolone, are prescribed to reduce nerve inflammation. Side effects may include insomnia, increased blood pressure, mood swings and fluid retention.
  • Plasma exchange (plasmapheresis). The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then mixed with a protein solution (albumin) and put back into your body. Plasma exchange may be used if your symptoms are severe and haven't responded to steroids.

Treatments to modify progression

No therapies have shown benefit for slowing the progression of primary-progressive MS. For relapsing-remitting MS, certain medications can lower the relapse rate and reduce the rate of formation of new lesions, particularly early in the disease course.

The options include:

  • Beta interferons. These medications, which are injected under the skin or into muscle, can reduce the frequency and severity of relapses. Beta interferons can cause side effects such as flu-like symptoms and injection-site reactions. You'll need blood tests to monitor your liver enzymes.
  • Glatiramer acetate (Copaxone). This medication may help block your immune system's attack on myelin. The medication must be injected beneath the skin. Side effects may include skin irritation at the injection site.
  • Dimethyl fumarate (Tecfidera). This twice-daily oral medication can reduce relapses. Side effects may include flushing, diarrhea, nausea and lowered white blood cell count.
  • Fingolimod (Gilenya). This once-daily oral medication reduces relapse rate. You'll need to have your heart rate monitored for six hours after the first dose because your heartbeat may be slowed. Other side effects include high blood pressure and blurred vision.
  • Teriflunomide (Aubagio). This once-daily medication can reduce relapse rate. Teriflunomide can cause liver damage, hair loss and other side effects. It is also known to be harmful to a developing fetus.
  • Natalizumab (Tysabri). This medication is designed to block the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. The medication increases the risk of a viral infection of the brain called progressive multifocal leukoencephalopathy. It is generally given to people who have more severe or active MS, or who do not respond to or can't tolerate other treatments.
  • Mitoxantrone (Novantrone). This immunosuppressant drug can be harmful to the heart and is associated with development of blood cancers. Mitoxantrone is usually used only to treat severe, advanced MS.

Treatments for signs and symptoms

  • Physical therapy. A physical or occupational therapist can teach you stretching and strengthening exercises, and show you how to use devices that can make it easier to perform daily tasks.
  • Muscle relaxants. You may experience painful or uncontrollable muscle stiffness or spasms, particularly in your legs. Muscle relaxants such as baclofen (Lioresal, Gablofen) and tizanidine (Zanaflex) may help.
  • Medications to reduce fatigue.
  • Other medications. Medications may also be prescribed for depression, pain, and bladder or bowel control problems that are associated with MS.
July 10, 2014