Multiple sclerosis (MS) is an autoimmune disease. The body’s immune system attacks the myelin (fatty sheath) that insulates nerves in the brain and spinal cord, which make up the central nervous system. This process results in lesions that cause MS symptoms.

There are now more treatment options for MS than ever before. They fall into three main categories: disease-modifying therapies (DMTs), medications used to treat relapses, and medications for managing MS symptoms.

To read about specific MS treatments, visit Treatments A-Z.

Disease-Modifying Therapies

DMTs are aimed at suppressing elements of the immune system involved in autoimmune attacks. DMTs are considered maintenance treatments and are taken long-term to help prevent disease flares and slow MS progression.

Most health care providers and researchers agree that beginning DMT as soon as possible after diagnosis and taking it consistently without interruptions are key factors in successfully managing MS.

The United States Food and Drug Administration has approved several different DMTs.

Different classes of DMTs work in multiple ways. Depending on the particular medication, DMTs can be administered by various routes and on different dosage schedules.

Injection at Home

The following medications can be injected under the skin at home:

• Avonex (interferon beta-1a)
• Betaseron (interferon beta-1b)
• Copaxone (glatiramer acetate)
• Kesimpta (ofatumumab)
• Rebif (interferon beta-1a)

Intravenous Infusion

Other medications are infused intravenously at a clinic:

• Lemtrada (alemtuzumab)
• Novantrone (mitoxantrone)
• Ocrevus (ocrelizumab)
• Tysabri (natalizumab)

Oral Medications

Medications taken orally (pills or capsules) include:

• Aubagio (teriflunomide)
• Gilenya (fingolimod)
• Mavenclad (cladribine)
• Mayzent (siponimod)
• Ponvory (ponesimod)
• Tecfidera (dimethyl fumarate)
• Zeposia (ozanimod)

Treatment for Different Types of MS

Some disease-modifying MS medications, such as Mayzent and Mavenclad, are only approved to treat relapsing forms of MS. These 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 magnetic resonance imaging (MRI) findings consistent with MS— or who have had their first clinical episode but have not yet been definitively diagnosed with MS.

Side Effects of Disease-Modifying Therapy

Eligibility for some MS medications depends on whether you test positive for a common virus called the John Cunningham virus (JCV), which can cause serious side effects. Depending on which MS treatment you’re 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.

Because DMTs suppress aspects of the immune system, many of these MS treatments can increase your risk of contracting infections and, in rare cases, developing certain types of cancer. Each MS treatment has specific side effects and different risk levels. Your doctor can help you understand the risks and benefits of each MS medication based on your medical history and individual condition.

Shared Decision-Making

Shared decision-making is an effective approach to MS care in which treatment decisions are made as a collaboration between you and your doctor. Your doctor will provide information about the risks versus benefits of different treatment options, make recommendations, and answer your questions. You will communicate your preferences, priorities, and values to your doctor. Together, you will decide on the best treatment option.

Medication for Relapses

During acute MS relapses (also called flare-ups or exacerbations), additional medications may be given temporarily to treat symptoms and get the disease back under control. Standard treatment options for relapses include 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, if taken long term, corticosteroids can cause side effects including osteoporosis, cataracts, and serious metabolic disorders such as diabetes and Cushing syndrome.

Symptom Management Medications

MS can cause a wide array of motor, cognitive, and general symptoms that have an impact on daily activities. When symptoms become severe, they can cause disability.

Some MS treatments can help manage some symptoms of the disease. Although these MS medications can improve function and quality of life, they do not treat the underlying disease or prevent its progress.

Various therapies can target different disease symptoms:

• 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 alleviate depression, 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.

Other available therapies include plasmapheresis, also called therapeutic plasma exchange, a technique that removes, filters, and replaces the blood plasma of a person undergoing treatment. Plasmapheresis may be used to treat symptoms of MS, especially for people who cannot tolerate high doses of steroids.

Some people with MS find relief from certain MS symptoms by using complementary or alternative treatments such as medical cannabis, herbal supplements, or acupuncture.

Is There a Cure for MS?

Despite ongoing research, there is currently no cure for MS. The good news is that although MS is not yet curable, it is treatable.

Can Diet Help MS?

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 a 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
• 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

• Multiple Sclerosis (MS) — An Overview
• Multiple Sclerosis Types
• What Causes MS?
• Symptoms of Multiple Sclerosis
• Multiple Sclerosis — The Path to Diagnosis