Multiple Sclerosis

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Treatment for Specific MS Symptoms

Treatment for specific symptoms of multiple sclerosis may include the following:

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Muscle weakness, numbness, and stiffness (spasticity) may be treated using medication taken regularly or as needed. These drugs include muscle relaxants, such as tizanidine (Zanaflex®) and baclofen (Loresal®), benzodiazepines, such as diazepam (Valium®), and anticonvulsants, such as carbamazepine (Tegretol®).

Side effects of baclofen and tizanidine include drowsiness, dizziness, and fatigue. These drugs should not be discontinued abruptly. Carbamazepine may cause severe side effects including aplastic anemia, low white blood cell count (leukopenia), cancer that develops in cells found in blood and lymph (lymphoma), heart failure, and seizures.

Fatigue may be treated using amantadine hydrochloride (Symmetrel®) or modafinil (Provigil®) when frequent napping, adequate sleep at night, and daily exercise do not help. Side effects include nausea, dizziness, and headache.

Balance and equilibrium abnormalities (e.g., difficulty walking, uncoordinated movements, tremor) may be treated using medications such as benzodiazepines (Valium®), clonazepam (Klonopin®), propranolol (Inderal®), and mysoline (Primidone®). Side effects include drowsiness, confusion, and depression.

Bladder dysfunction (e.g., incontinence, nocturia) may be treated using medications such as oxybutynin (Ditropan®), tolterodine (Detrol®), and hyosciarnine (Levsin®). Bladder-emptying regimen, intermittent catheterization, and surgery may also be used. Side effects of medication include headache, dry mouth, constipation, and dizziness.

Constipation may be worsened by inactivity. Treatment includes eating a high-fiber diet, increasing fluid intake, daily exercise, and stool softeners. Rectal suppositories or enemas occasionally may be required.

Sexual dysfunction may occur in men and women with MS. Treatment is available for erectile dysfunction and female sexual dysfunction.

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