There are now more treatments for MS than ever before. MS treatments fall into three main categories: disease-modifying medications, medications used to treat relapses, and medications for managing MS symptoms.
For details about specific MS treatments, visit Treatments A-Z.
In MS, the body’s immune system attacks the myelin that insulates nerves in the brain and spinal cord, creating the lesions that cause MS symptoms. Disease-modifying MS treatments are aimed at suppressing elements of the immune system involved in these autoimmune attacks. Disease-modifying multiple sclerosis medications are considered maintenance treatments, and are taken long-term to help prevent disease flares and slow the progression of MS. Most doctors and researchers agree that beginning disease-modifying treatment as soon as possible after diagnosis and taking it consistently without interruptions are key factors in successfully managing MS.
Disease-modifying medications are taken in various ways. Many disease-modifying MS treatments are administered by injection. Medications such as Avonex (Interferon beta 1a), Rebif (Interferon beta 1a), and Copaxone (Glatiramer acetate) can be self-administered at home with subcutaneous or intramuscular injections. Other medications like Lemtrada (Alemtuzumab), Tysabri (Natalizumab), Ocrevus (Ocrelizumab), and Novantrone (Mitoxantrone) must be infused intravenously at a clinic. Oral medications Aubagio (Teriflunomide), Tecfidera (Dimethyl fumarate), Gilenya (Fingolimod), Mavenclad (Cladibrine), and Mayzent (Siponimod) are also available.
Some disease-modifying multiple sclerosis medications are only approved to treat relapsing forms of MS, which include relapsing-remitting MS and cases of progressive MS in which people continue to experience relapses. Other MS treatments are also indicated for people who have MRI features consistent with MS, or who have had their first clinical episode but have not yet been definitively diagnosed with MS. Currently Ocrevus is the only drug approved by the U.S. Food and Drug Administration to treat primary progressive MS. Mayzent, Mavenclad, and Novantrone are the only medications approved to treat secondary progressive MS. Eligibility for some multiple sclerosis medications depends on whether you test positive for a common virus called the John Cunningham virus (JCV) that can cause serious side effects. Depending on which MS treatment you are on, you may need to undergo regular blood tests for JCV while taking it, and switch to a different treatment if your JCV levels become too high.
Since disease-modifying medications suppress aspects of the immune system, many of these multiple sclerosis treatments can increase your risk for contracting infections and, in rare cases, developing certain types of cancer. Each MS treatment has specific side effects and different levels of risk. Your doctor can help you understand the benefits and risks of each multiple sclerosis medication based on your medical history and individual condition.
During acute MS relapses (also called flare-ups or exacerbations), additional medications may be given on a temporary basis to treat symptoms and get the disease back under control. The most important of these are corticosteroids such as Solu-Medrol (Methylprednisolone) and the closely related drug Acthar Gel. Corticosteroids, also called steroids, are medications that simulate the effects of the hormone cortisol produced in the body’s adrenal glands. Corticosteroids are powerful medications that suppress immune activity and relieve inflammation. As MS treatments for flare-ups, corticosteroids may be given intravenously or taken orally.
Taken for short periods of time, corticosteroids are safe and effective for MS flare-ups. However, taken long-term, corticosteroids can cause serious side effects including osteoporosis, cataracts, and serious metabolic disorders such as diabetes and Cushing syndrome.
MS can cause a wide array of motor, cognitive, and general symptoms that impact daily activities. When symptoms become severe, they can cause disability. There are MS treatments that can help manage some symptoms of the disease. While these multiple sclerosis medications can improve function and quality of life, they do not treat the underlying disease or prevent its progress.
Ampyra (Dalfampridine) can improve walking problems. Muscle relaxants such as Zanaflex (Tizanidine), Flexeril (Cyclobenzaprine), and Lioresal (Baclofen) can help with spasticity. Antidepressants such as Cymbalta (Duloxetine), Prozac (Fluoxetine), and Zoloft (Sertraline) can address depression, and certain antidepressants have been shown to relieve fatigue or neuropathic pain. Elavil (Amitriptyline) and Neurontin (Gabapentin) can also help with MS-related pain. Nuedexta (Dextromethorphan/Quinidine) is prescribed to treat pseudobulbar affect, a symptom of MS that causes intense bouts of laughter or crying not reflective of the person’s actual feelings. Provigil (Modafinil) can be taken to combat fatigue and “brain fog,” or cognitive difficulties. Other medications are available to address bowel, bladder, and sexual dysfunction, as well as vertigo and tremors.
Some people with MS find relief from certain MS symptoms by using complementary or alternative treatments such as medical cannabis, herbal supplements, or acupuncture.
Despite encouraging research toward finding a multiple sclerosis cure, there is at present no cure for MS. The good news is that while MS is not currently curable, it is treatable.
Like everyone else, people with MS feel their best when they consistently eat a healthy, balanced diet. Most physicians who specialize in MS recommend the same low-fat, high-fiber diet recommended by the American Cancer Society and American Heart Association. Clinical studies have shown some benefits – better quality of life, lower rates of disability, possibly even fewer relapses and slower disease progression – for people with MS when they adhere to a diet low in saturated fat, get enough Vitamin D, and supplement with omega-3 and omega-6 fatty acids. It is also proven that some MS symptoms are made worse by certain foods; if you avoid them, these symptoms can improve.
A balanced, nutritious diet can also help you maintain a healthy weight and lower your risk for developing dangerous chronic conditions such as diabetes, osteoporosis, and heart disease.
MS Condition Guide
Is there a natural cure for MS?
There is no cure for MS at the present time. No natural, alternative treatments have been proven effective in clinical studies to prevent relapses or delay disease progression. However, many people with MS have found various complementary or alternative therapies effective for improving MS symptoms such as pain, bladder problems, spasticity, and fatigue. Since some natural or complementary treatments can interfere with MS medications or cause their own side effects, it is important to talk to your doctor before trying any alternative treatments.
What are the side effects of multiple sclerosis treatments?
Any medication can cause side effects. Each MS treatment has specific potential side effects associated with it. This does not mean that anyone who takes that multiple sclerosis medication will experience all, most, or any of the side effects it can potentially cause. Some side effects are very common, while some are extremely rare. Your doctor can help you assess the risks and benefits of each MS treatment as they relate to your medical history and condition.
Which multiple sclerosis treatments should I avoid?
Some MS treatments carry a higher risk of causing serious side effects than others. For this reason, there are established guidelines for which multiple sclerosis treatments should be tried first, and which should be reserved for people who do not show improvement on the first-line treatments. However, with any medication, your risk of experiencing serious side effects depends on the details of your condition and personal and familial medical history. For instance, some multiple sclerosis medications carry a higher risk for people with kidney or liver problems, heart disease, or increased rates of certain cancers in their family. For another example, some MS treatments cannot be prescribed to those with high levels of JCV in their blood because the virus can cause a potentially fatal brain infection called progressive multifocal leukoencephalopathy (PML). For those who test negative for the JCV, the risk of contracting PML is extremely low. With any disease-modifying multiple sclerosis medication, the risk of serious side effects must be weighed against the benefit of clinically proven effectiveness in preventing the development of new MS lesions, reducing the frequency of flares, and delaying the progression of the disease.
Can I get assistance paying for multiple sclerosis medications?
Most people with private or employer-sponsored health insurance are eligible for copay assistance programs – many with a $0 copay – through the manufacturers of disease-modifying MS treatments. Some people with low income and no health insurance may qualify for free multiple sclerosis medications through non-profit organizations or drug manufacturers. You can find more information on copay assistance programs here.