Medications used for MS Patients

Below is a list of medications most commonly used to treat MS. Those highlighted in red are the ones I've taken since being diagnosed six and a half years ago. Currently, I am not on any disease modifying treatments due to liver issues caused by the medications. Eventually, I'll begin treatment again.

Brand Name*	Chemical Name	Usage in MS
	amantadine	Fatigue
	mineral oil+	Constipation
	papaverine	Erectile dysfunction
Ampyra	dalfampridine (formerly called fampridine, 4-aminopyridine)	Walking
Antivert (US) Bonamine (Can)	meclizine	Nausea; vomiting; dizziness
Atarax	hydroxyzine	Paroxysmal itching
Avonex	interferon beta-1a	Disease-modifying agent
Bactrim; Septra	sulfamethoxazole	Urinary tract infections
Betaseron	interferon beta-1b	Disease-modifying agent
Botox	onabotulinumtoxin A	Spasticity in the upper limbs
Botox	onabotulinumtoxin A	Bladder dysfunction
Cialis	tadalafil	Erectile dysfunction
Cipro	ciprofloxacin	Urinary tract infections
Colace	docusate+	Constipation
Copaxone	glatiramer acetate	Disease-modifying agent
Cymbalta	duloxetine hydrochloride	Depression, pain (neuropathic)
Dantrium	dantrolene	Spasticity
DDAVP Nasal Spray	desmopressin	Urinary frequency
DDAVP Tablets	desmopressin	Urinary frequency
Decadron	dexamethasone	Acute exacerbations
Deltasone	prednisone	Acute exacerbations
Detrol (US)	tolterodine	Bladder dysfunction
Dilantin	phenytoin	Pain (dyesthesias)
Ditropan	oxybutynin	Bladder dysfunction
Ditropan XL	oxybutynin (extended release formula)	Bladder dysfunction
Dulcolax	bisacodyl+	Constipation
Effexor	venlafaxine	Depression
Elavil	amitriptyline	Pain (paresthesias)
Enablex	darifenacin	Bladder dysfunction
Enemeez Mini Enema	docusate stool softener laxative+	Constipation
Extavia	interferon beta-1b	Disease-modifying agent
Fleet Enema	sodium phosphate+	Constipation
Flomax	tamsulosin	Bladder dysfunction
Gablofen	baclofen (intrathecal)	Spasticity
Gilenya	fingolimod	Disease-modifying agent
H.P. Acthar Gel	adrenocorticotropic hormone (ACTH)	Acute exacerbations
Hiprex; Mandelamine	methenamine	Urinary tract infections (preventative)
Hytrin	terazosin	Bladder dysfunction
Intrathecal Baclofen (ITB Therapy)	baclofen (intrathecal)	Spasticity
Klonopin (US) Rivotril (Can)	clonazepam	Tremor; pain; spasticity
Laniazid; Nydrazid	isoniazid	Tremor
Levitra	vardenafil	Erectile dysfunction
Lioresal	baclofen	Spasticity
Macrodantin	nitrofurantoin	Urinary tract infections
Metamucil	psyllium hydrophilic mucilloid+	Constipation
Minipress	prazosin	Bladder dysfunction
MUSE	alprostadil	Erectile dysfunction
Neurontin	gabapentin	Pain (dysesthesias)
Nuedexta	dextromethorphan + quinidine	Pseudobulbar affect
Novantrone	mitoxantrone	Disease-modifying agent
Oxytrol (Oxybutynin Transdermal System)	oxybutynin	Bladder dysfunction
Pamelor (US) Aventyl (Can)	nortriptyline	Pain (parasthesias)
Paxil	paroxetine	Depression
Phillips' Milk of Magnesia	magnesium hydroxide+	Constipation
Pro-Banthine	propantheline bromide	Bladder dysfunction
Prostin VR	alprostadil	Erectile dysfunction
Provigil	modafinil	Fatigue
Prozac	fluoxetine	Depression; fatigue
Pyridium	phenazopyridine	Urinary tract infections (symptom relief)
Rebif	interferon beta-1a	Disease-modifying agent
Sanctura	trospium chloride	Bladder dysfunction
Sani-Supp suppository (US)	glycerin+	Constipation
Solu-Medrol	methylprednisolone	Acute exacerbations
Tegretol	carbamazepine	Pain (trigeminal neuralgia)
Tofranil	imipramine	Bladder dysfunction; Pain
Tysabri	natalizumab	Disease-modifying agent
Valium	diazepam	Spasticity (muscle spasms)
Vesicare (US)	solifenacin succinate	Bladder dysfunction
Viagra	sildenafil	Erectile dysfunction
Wellbutrin	bupropion	Depression
Zanaflex	tizanidine	Spasticity
Zoloft	sertraline	Depression

MS Pain

It’s very difficult to express to others the specific pain that comes with an invisible disease. For me, I do everything I can to prevent anyone from noticing what MS does to me. Recently (within the last few months), the chronic pain I’ve experienced has gotten worse. Additionally, having to explain to others the pain I’m experiencing when I don’t even know how to comprehend it is frustrating and, well, sad. Unfortunately, most of the time when I’m experiencing an increase in pain, the questions I receive from others goes as far as angering me because, in my mind, these individuals should know if they are in my life. I’ve discovered that no one will ever truly comprehend the extent or complexity of MS unless they are in my (or another patient’s) shoes.

From an article in Overview of Pain as a Symptom of Multiple Sclerosis, MS pain is highlighted:

Multiple sclerosis (MS) can be very painful, although many people do not realize the extent to which MS can cause pain and discomfort. I know that it is hard to find words to describe the MS hug or the incessant feeling like ants are biting the soles of your feet. However, the fact that these things are so unique to MS can result in a lack of understanding and empathy, just when you need it the most.

Furthermore, from A.S.A.M.I.E.F., MS pain is highlighted:

NEW HAVEN, Conn. (Reuters Health) - A large-scale survey of more than 7,000 multiple sclerosis (MS) patients shows that most MS patients are undertreated and often unrecognized for pain management.

Yale University neurologist Dr. Marco Rizzo presented these findings last week here at the 15th Yale Neuroimmunology Symposium.

``MS patients experience migraine headaches, eye, leg, facial, bladder and skin pain. Muscular spasms and prickling or tingling sensations of the skin are common, and the pain is chronic,'' Rizzo explained.

MS is a central nervous system disorder in which the thin protective coating called myelin that insulates nerve fibers in the brain and spine becomes damaged. Eventually, lesions develop in the brain and spinal cord that can lead to a loss of vision, weakness, numbness and tingling.

MS occurs when white blood cells known as T cells attack the proteins that make up myelin. Currently, there is no cure for the disease.

Chronic pain causes ``miswiring,'' leading to abnormal pain pathways, Rizzo noted. Typical pain medications do not work in chronic pain and so MS patients need to be treated with medications such as a class of antidepressants known as tricyclic antidepressants, and anticonvulsants. Typically, more than one medication or combination needs to be given in order to effectively tackle the pain, Rizzo pointed out.

Tired vs. Fatigue

I've been asked numerous times about the differences in being tired and being fatigued. Below, an incredible piece from the Patient Experience highlights the differences:

…tiredness can […] be alleviated by rest. On the other hand fatigue is often the product of a chronic medical condition. It can lead to anxiety, light sensitivity, difficulty in sleeping and depression. Many people with fatigue go on find themselves almost in a state of delirium and exhaustion and it is difficult for them to carry on their previous lifestyles.

On the News Medical web site Dr Olson said “”It is important to recognize the difference between tiredness and fatigue, because fatigue is a marker that the body is not able to keep up. The onset of the manifestations of fatigue, particularly if these are not normal states for you, should be taken seriously.”

One of Dr Olson’s pieces of advice is to avoid caffeine and other stimulants which in the long term can lead to greater fatigue.

MS Facts

• More than 400,000 people in the United States have MS.
• An estimated 2,500,000 around the world have MS.
• About 45 percent of the people with MS are not severely affected by the disease.
• Diagnosis of MS is usually between 20 and 40 years of age.
• MS affects more women than men, with a ratio of 2:1.
• About 85 percent of those who are newly diagnosed have the relapsing-remitting form of MS.
• Without disease-modifying therapy, about 50 percent of those diagnosed with relapsing-remitting MS will become progressive at 10 years.
• Without disease-modifying therapy, about one-third of those diagnosed with relapsing-remitting MS will be using a wheelchair at 20 years.
• MS does not significantly affect life span.
• The course of the disease is unpredictable and no two people will experience the same set of symptoms.
• There are four types of MS: relapsing-remitting, secondary-progressive, primary progressive and progressive relapsing.
• Among young adults, MS is the most common disease of the central nervous system.
• Fatigue is one of the most common symptoms of MS.
• MS is not contagious.
• MS is a progressive disease for which there is not yet a cure.
• Increased understanding of MS has led to the development of many new treatments that target both the disease process and its many symptoms.
• Sclerosis is a Greek word meaning hardening of tissue or scars.
• MS is not inherited or genetically transmitted, although there does seem to be some genetic susceptibility to the disease.

*Conclusion* Part VI

As a patient who has had MS for over six years, returning to work and returning to the normal routine of daily life seemed near impossible. However, after being empowered with knowledge, although the understanding of the disease was far from over, it was easier to explain the progression and unpredictability of the disease to family, friends, colleagues, and employers. Additionally, the knowledge gained allowed for an easier transition back into the professional environment primarily due to explaining what accommodations may be needed. However, it is imperative to remember that simple accommodations used to help with fatigue, motor weakness, bowel and bladder control, loss of sensation, cognitive challenges, and unpredictability will allow an individual with MS to lead a much more productive and happy professional life.