A potentially disabling disease of the brain and spinal cord, there are no specific treatments for multiple sclerosis to cure the condition. The main focus of treatment is to manage the symptoms and help the patient lead a normal life. For this purpose, medications in the form of oral and intravenous drugs and infusions are used. Additionally, invasive and noninvasive approaches are used to calm down an attack and prevent its recurrence.

1. Oral drugs: Corticosteroids
An example of this is oral prednisone. Usually, large doses of steroids can reduce the duration of the attack and prevent relapse to a certain extent. The usual dose recommended is 1 mg/kg, but it may vary depending on the patient and the dose can be tapered gradually depending on symptoms.

• Fingolimod
  This helps relapsing-remitting multiple sclerosis by preventing the lymphocytes (a certain type of immune cells that play a vital role in defending the body from antigens) from attacking the cells of the brain and spinal cord.
• Teriflunomide
  This helps to inhibit the de novo pyrimidine synthesis, which is a pathway that impacts the DNA and proliferates the disease. This medication blocks this pathway and prevents the T cells and B cells from evading the blood-brain barrier and getting into the central nervous system, which might impact the patient’s mobility and cause disability.
• Dimethyl fumarate
  This helps in combating relapsing multiple sclerosis and decreases the inflammatory response.

2. Injectables

• IV methylprednisolone
  The dosage varies between 500 and 1000 mg and helps to a large extent in bringing down the inflammation of the myelin sheath around the nerves.
• Baclofen
  This acts as a skeletal muscle relaxant and aids in muscle spasticity.
• Interferons
  These help in treating relapsing forms of multiple sclerosis. Interferons, in general, are substances produced naturally by the body, but in cases of multiple sclerosis, these substances may have been hindered to protect the immune system due to the cells undergoing changes, so new interferons are injected to prevent relapses and to guard the nerve cells against being attacked further. The different types of interferons administered in the treatments for multiple sclerosis are interferon beta-1a, interferon beta-1b, interferon beta-1b, peginterferon beta-1a, and interferon beta-1a.

3. Infusions

• Ocrelizumab
  This is a type of monoclonal antibody that is infused twice a year to treat relapsing multiple sclerosis or primary multiple sclerosis by targeting the CD20 positive B cells, which are responsible for the proliferation of the disease. This treatment may increase the chances of developing some types of cancer and infusion-related side effects include irritation at the site of injection, fever, nausea, and low blood pressure among others.
• Natalizumab
  This helps in preventing the infected cells from reaching the brain and spinal cord and also prevents the formation of new brain lesions. It aids in calming down or curbing the symptoms of multiple sclerosis such as tremors and other neurological conditions.
• Mitoxantrone – It is an antineoplastic agent used during treatments for multiple sclerosis (relapsing-remitting). It interrupts the DNA synthesis and proliferation of the B cells and T cells, which cause the progression of multiple sclerosis. This agent hampers disease progression.