Treating Multiple Sclerosis
Although
there is no prevention or cure for people with
multiple sclerosis, there are a number of drugs
available that slow down the progress of this
disease. These medications are known as disease
modifying drugs. Avonex, Betaseron, Copaxone,
Novantrone and Rebif are some of the drugs approved
by the FDA in the treatment of MS.
All these drugs work by altering or suppressing
activity in the immune system. This is because
in MS the body’s own immune system attacks
the nerve cells, for reasons unknown to scientists.
These drugs are not a cure; they reduce the frequency
and severity of MS symptoms, and delay its progression.
All these drugs are known to improve the quality
of life for people with multiple sclerosis, and
for this reason most doctors suggest that they
be started right away after diagnoses of relapsing-remitting
MS is made. Relapsing-remitting MS as defined
as the period in which symptoms of MS worsen,
and are then followed by periods of full or partial
recovery with no symptoms. These attacks can occur
over several weeks and recovery from these attacks
can take months for some, during this time however,
MS does not worsen. This pattern of attacks is
fairly common in most people suffering from MS.
The decision to implement drug therapy should
be made after a thorough discussion with your
doctor. You need to consider all the benefits
and side effects before you take any of the above
mentioned medications. The most important aim
of this therapy should be to find a treatment
that you can be most comfortable in.
Avonex, Betaseron &
Rebif
These three drugs are known as interferon beta
medications. Interferon's are a group of alpha,
beta and gamma proteins in the immune system that
act in different ways to control the immune system
in the body. They also have antiviral properties.
Scientists believe that interferon beta is very
effective in treating MS.
Avonex is an FDA approved drug used in the treatment
of relapsing MS. It not only reduces the progression
of this disease, but also reduces the size of
lesions in the brain and delays the frequency
of exacerbations or attacks. It is an inter-muscular
drug.
Betaseron also treats the relapsing form of MS,
and reduces the number of MS attacks, their frequency,
and severity. Additionally this FDA approved drug
also stabilizes the size of brain lesions. It
is given subcutaneously every other day.
Also used for treating relapsing MS, Rebif has
been approved by the FDA and has proven effective
in reducing brain lesions, frequency of relapses,
and delaying some of the disabilities associated
with MS.
As all these three drugs are Interferon betas,
they have similar side effects which include;
flu-like symptoms, including chills, fatigue,
muscle aches and sweating, reactions at the site
of the injection like redness, swelling and pain
and these drugs can also cause depressive symptoms
like sadness, anxiety, irritability, guilt, poor
concentration, sleeplessness, lack of appetite
and confusion. If the latter side effects occur,
it is imperative that you speak to your doctor
immediately.
Pregnant women and women tying to get pregnant,
along with people suffering from depression and
who have liver function problems need to take
special precautions when using any of these three
medications. Interferon drugs can also affect
blood cells and thyroid functioning as well.
Copaxone
Copaxone is an artificial protein that resembles
a protein that is part of the myelin. It works
by altering the activity of the immune system.
Copaxone is used to treat the relapsing-remitting
form of MS, and is administered subcutaneously,
once a day. It only reduces the frequency of attacks,
it bodes not reduce or delay disability.
Side effects of Copaxone include; nausea; weakness;
redness, pain and swelling at the injection site,
and chest pain or tightness. This feeling of chest
tightness lasts only a few minutes and then goes
away.
Pregnant women, women trying to get pregnant
and breast-feeding women should not use this medication.
Novantrone
Novantrone is another immunosuppressive drug that
slows disability and reduces the rate of relapse
in people with relapsing-remitting MS. It also
reduces the formation of new lesions in the brain.
Novantrone is administered intravenously via
a drip, and treatment takes place after every
three months. Before treatment commences however,
tests need to be conducted to determine your overall
health, especially your blood cell count, and
an EKG and an echocardiogram to detect the strength
of your heart. This treatment lasts two hours,
during which time you are given Novantrone, IV
Solu-Medrol (steroid medicine), Zofran (an anti-nausea
drug), and IV fluids through an IV drip. As Novantrone
suppresses your immune system, you will have an
increased risk of infection after treatment. It's
important to avoid contact with people who are
sick.
Side effects from Novantrone include; a blue-green
color of urine for 24-hours after receiving Novantrone,
a temporary bluish color of the whites of the
eyes, mild or moderate nausea, flu-like symptoms,
stomach pain or discomfort, sore mouth, headaches,
diarrhea, pain, swelling, redness, or irritation
at the injection site, unusual bleeding or bruising,
chest pain or discomfort, difficulty breathing,
wheezing, an irregular heartbeat, swollen feet
or ankles and mild to moderate hair loss. However,
if you experience; fever and flu-like symptoms,
shortness of breath, vomiting, diarrhea, rapid
heartbeats or swollen feet, call your doctor immediately.
Treating MS With IV
Steroids – Solu-Medrol
Solu-Medrol is a powerful steroid that eases inflammation
and treats acute attacks of MS. During an acute
attack of multiple sclerosis, there is a distinct
increase in the severity of symptoms. New symptoms
may appear, or your existing symptoms worsen.
An attack of this sort usually comes with inflammation.
Steroid treatment is recommended if the symptoms
are severe. When an acute attack occurs you receive
Solu-Medrol at a treatment center each day for
one to five days, depending on your treatment
plan. Not everyone experiences side effects from
this treatment, but the most common are: stomach
irritation, increased energy, rapid heartbeat,
facial flushing, feeling warm or cold, fluid retention,
mood changes, insomnia and nausea. Some long-term
side effects of steroids include: osteoporosis,
stomach ulcers, cataracts, weight gain, acne and
diabetes.
Cytoxan Therapy
Cytoxan therapy works by suppressing the immune
system. It slows down MS by keeping white blood
cells from attacking the central nervous system.
It is administered intravenously by drip. Unfortunately,
Cytoxan has serious side effects, which you need
to be aware of before you try this therapy. Its
side effects include: nausea, hair thinning/loss
and a low white blood cell count. To control nausea
associated with Cytoxan therapy, you will be given
either Zofran or Reglan. During treatment, you
will be given a combination of Cytoxan, Solu-Medrol,
Zofran and/or Reglan, and IV fluid via a drip.
As Cytoxan suppresses your immune system, you
will be prone to infections after treatment. And
will need to avoid contact with people who are
sick, especially the first 12-14 days.
Imuran Therapy
Imuran is another immunosuppressant that can be
used to slow the progression of MS in people who
are not responding well to other treatments. It
may also be used with other disease-modifying
therapies, such as Avonex, to boost its effect.
It is an oral medication, taken twice a day. It
is important that you take this medication regularly
as prescribed; and do not stop taking it unless
advised by your doctor. Possible side effects
from Imuran include; increased stomach irritation,
vomiting, changes in hair color and texture along
with hair loss, loss of appetite, blood in the
urine or stool, unusual bruising, fatigue and
development of mouth sores and ulcers. And like
other immunosuppressant's, it increases your risk
for infection, so it is important to take care
of yourself. If you contract an infection its
is important to see your doctor right away.
Intrathecal Baclofen
Pump Therapy
Baclofen is a medication commonly used to decrease
muscle spasticity related to multiple sclerosis,
spinal cord injuries and other neurological diseases.
Spasticity is defined by tightness or stiffness
of muscles that interfere with voluntary muscle
movement. Baclofen works by restoring and reducing
muscle hyperactivity, allowing for more normal
muscle movements. Side effects from Baclofen include:
dizziness, drowsiness, headaches, nausea and weakness.
The intrathecal Baclofen pump therapy is the way
doctors give this drug directly into the spinal
fluid. The system is surgically placed under the
skin of the abdomen near the waistline, and releases
prescribed amounts of medicine through a catheter.
Anyone who has spasticity that is not responsive
to oral treatment is a candidate for this therapy.
The advantage of this therapy is that it efficiently
reduces spasticity and involuntary spasms, promoting
a more active lifestyle, better sleep, and reduces
need for oral medications. The disadvantage is
that there are certain risks that must be considered
with any surgery. The risks include: an adverse
reaction to anesthesia, infection, bleeding and
bladder control can be altered. Pump malfunctions
can also occur.
Deep Brain Stimulation
Deep brain stimulation (DBS) is used to treat
tremors in people with multiple sclerosis, and
Parkinson's disease. In DBS, the doctor inactivates
the thalamus or globus pallidus parts of the brain,
by placing the tip of an electrode in the thalamus
or in the globus pallidus. Deep brain stimulation
offers many advantages, but it does not cure MS.
It is only able to relieve the symptoms of tremors
in MS.
Treating Multiple Sclerosis With Botox
Botulinum toxin or botox (for short) is a muscle
relaxing medication used to decrease spasticity
related to multiple sclerosis. Botulinum toxin
is derived from Clostridium Botulinum, a bacterium
and is in a class of drugs called neurotoxins.
Despite the drug's effectiveness, the FDA has
yet to approve the use of botox to treat MS-related
spasticity. |
