Multiple sclerosis is the most common disabling neurological disease in young adults, according to the National Institutes of Health. Multiple sclerosis treatment guidelines are set in order to treat acute attacks, prevent relapses and the progression of the disease, manage symptoms, and manage rehabilitation. Since the disease can range from being relatively benign to disabling or devastating, multiple sclerosis treatment will vary from person to person.
Unless an attack is mild, the multiple sclerosis treatment guidelines call for 1000 mg of methylprednisolone given intravenously for three days. However, protocols may differ between clinicians. Sometimes patients will be prescribed oral doses of prednisone for two or more weeks to taper them off of the treatment. Patients are usually not admitted into a hospital unless their problems are severe.
The progression of the disease and the severity of relapses have been shown to be decreased by new drugs since the mid-1990s. One of these disease modifying drugs is interferon beta-1b, which is recommended in the 2007 multiple sclerosis treatment guidelines for treatment of the disease. Interferon beta-1a and glatiramer acetate are also included in these guidelines.
One in four of the patients who receive interferon beta-1b or subcutaneous interferon beta-1a will develop antibodies against the drug within two years. The same is said for one in twenty who receive intramuscular interferon beta 1-a. If these antibodies are present after two years of treatment, the patient will be switched to glatiramer acetate. If there are no antibodies present, no further test are needed.
The Management of Symptoms
Many of the symptoms of multiple sclerosis are manageable. Pain and spasms of the limbs usually respond to baclofen, while the emotional manifestations of the disease, such as pathological laughing or crying, can be managed with a tricyclic antidepressant. Fatigue is reduced in roughly half or the patients with the treatment of amantadine.
Symptoms which are more difficult to manage include pain, weakness, sexual dysfunction, dysesthesia, tremor, and cognitive changes. Various therapeutic approaches are used in the treatment of these.
Complementary and alternative medicines have not been thoroughly tested through randomized clinical trials, but three out of four patients with multiple sclerosis use these techniques. Often they visit these types of practitioners more than they do their doctors. Funding for research for these types of treatment is available, but it is not fully utilized because scientific interest in them is low and trials are difficult to design.