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Treating MS
In the 1990's
disease-modifying therapies became available. While MS is treated
for its symptoms, patients with MS have the opportunity to begin on
treatment that helps slow the level of disability. Disease modifying
therapies do not eliminate MS, however, it slows down the progress
of MS as well as reducing annual exacerbation rate. The following
therapies are the current approved medications available to persons
with MS:
Interferon Beta 1b
(Betaseron)
Betaseron is injected subcutaneously (under
the skin) every other day. Injections are done in the thighs,
buttocks and abdomen (areas rich in fat) to minimize pain and skin
reaction. Side effects of Betaseron can include redness, pain,
bruising, and shrinkage of tissue at the site and necrosis. There
are fewer skin reactions when injections are given in the
buttocks.
Flu like symptoms can also occur. Side effects can
include headache, fever, aches, chills, and sore muscles. The use of
acetaminophen or ibuprofen helps to ease flu like symptoms. Most
patients take the medication at bedtime so that side effects are not
as pronounced. However, many people experience an increase in their
MS symptoms temporarily after injection and the day after,
especially in the beginning of treatment.
Over time, a
percentage of people treated develop antibodies (proteins in the
blood). It has not been determined if this affects the medication's
effectiveness. Speak with your neurologist to obtain the latest
information on this subject.
Interferon Beta 1a
(Avonex)
Avonex is injected intramuscularly once a week.
Injections are given usually in the thighs, although some patients
inject in the arm area. Side effects of Avonex include flu like
symptoms including fever, headache, chills, and aches can occur.
Injections are usually done at bedtime and the use of acetaminophen
or ibuprofen is helpful in minimizing side effects.
As with
Betaseron, patients can also develop antibodies to the medication
and speaking with your neurologist is recommended to obtain the
latest information.
Rebif
Rebif is injected
subcutaneously (under the skin) three times a week. Injections are
done in the thighs, buttocks and abdomen (areas rich in fat) to
minimize pain and skin reaction. Side effects of Rebif can include
redness, pain, bruising, and shrinkage of tissue at the site and
necrosis. There are fewer skin reactions when injections are given
in the buttocks.
Flu like symptoms can also occur. Side
effects can include headache, fever, aches, chills, and sore
muscles. The use of acetaminophen or ibuprofen helps to ease flu
like symptoms. Most patients take the medication at bedtime so that
side effects are not as pronounced. However, many people experience
an increase in their MS symptoms temporarily after injection and the
day after, especially in the beginning of treatment.
Avonex,
Betaseron, and Rebif are interferon medications and very similar to
each other. With both, relapses appear to decrease by a third and
also help delay progression of disability. The ideal dose continues
to be debated and further studies are in
progress.
Glatiramer Acetate
(Copaxone)
Copaxone is injected subcutaneously daily. The
skin at the injection site reddens, however side effects are
minimal. No flu like symptoms occur when using Copaxone, however,
some people experience a brief episode of breathlessness and
flushing after injection. The cause of this side effect is unknown.
Injections are done either in the morning or evening, and as with
Avonex, Betaseron, and Rebif, relapse rate appears to be reduced by
a third.
Expectations
Some patients have no
significant exacerbations, others appear to experience the same
number of flare ups, while others worsen. It is essential to
remember that disease-modifying therapies do not reverse
pre-existing symptoms, and treatment varies from person to person.
Many patients still expect their pre-existing symptoms to improve
with therapy even though they have heard that this is not the case.
Therefore, before selecting a therapy, speak with your physician,
read the literature available, and then choose the therapy that is
best for you.
Alternative Therapies
Some patients prefer
an alternative approach to treatment their MS symptoms. Alternative
therapies generally are not prescribed by physicians due to lack of
scientific evidence but selected by the individual patient.
NOTE:Alternative therapies are not evaluated for
effectiveness or safety.
It is important to note that
alternative therapies are usually not covered under medical
insurance. While some patients firmly believe in alternative
therapies, it is recommended that patients discuss potential
therapies with their
physician.
Acupuncture
Acupuncture is the
belief that there is a balance in the body between to universal
forces. With acupuncture, fine needles are inserted into relevant
points and are stimulated by twisting the needle that is then
stimulated by an electro-acupuncture device. There is a slight prick
when the needle is inserted and patients experience a numbness or
tingling sensation. Because acupuncture promotes the release of
steroids, it may be useful in treating pain, however, acupuncture
does not alter the course of the
disease.
Aromatherapy
In Aromatherapy, highly
concentrated scented oils are either massaged on the body or
inhaled. Some patients find Aromatherapy helpful with relaxing,
however, it has no other specific use.
Cannabis
(Marijuana)
Some patients report that smoking marijuana
improves their spasticity, emotional state, and eases pain. Many
studies are currently being done at this time. The problem with
Marijuana is that it's not legally
available.
Chiropractic
This treatment is based
on physical manipulation and has no specific role in MS. It may be
useful in relieving back pain.
Cold
Immersion
Heat and humid conditions negatively affect and
MS patients' symptoms, cooling tends to have the opposite effect.
Cooling treatments (bath or pool) are safe and inexpensive and are
recommended for those whose symptoms are temperature
sensitive.
Herbal Medicine
Herbal medicines
have been around for thousands of years and it's been estimated that
half of medications prescribed by physicians are herbal. No herbal
therapies have ever been proven to be a beneficial treatment in MS.
It's important to note that because there is no dosage information,
the patient is not aware how much is too much and some herbal
medicines can be problematic and interfere with other
medication.
Bee Venom
Bee venom therapy
involves either injecting the extracts of venom or getting stung
once or more times per day. This treatment is painful and has not
been shown to be an effective therapy in
MS.
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