Fatigue and Multiple Sclerosis
Most of us with multiple sclerosis (MS) suffer from fatigue. In fact, an estimated 70% of people with MS say that fatigue is their most disabling symptom.While much of our fatigue comes from the disease process itself or MS-related heat intolerance, there are many secondary causes of fatigue in MS. One thing that may be contributing to your fatigue could actually be some of the medications that you are taking to slow your MS or deal with specific symptoms. If you suffer from MS-related fatigue, it is important to investigate all possible causes, including side effects from some of your medications.
Use of NSAIDs in Multiple Sclerosis
Nonsteroidal anti-inflammatory drugs (NSAIDs) are probably the most commonly used class of drugs in the world. These drugs work by blocking certain enzymes (Cox), which produce prostaglandins, which are chemicals produced by the body that promote pain, inflammation and fever.NSAIDs are widely available. They are preferred over other pain relief medications, because they do not tend to be addictive and, in most cases, do not produce the sedative effects of some of the other pain medications. People differ in their sensitivity to the NSAIDs, however, and some people may find that they contribute to their fatigue, especially at the higher doses.
Many people with MS take NSAIDs when they experience a new symptom, hoping that it will help. If you are experiencing a new symptom or a worsening symptom, it is important to see your doctor before launching on a self-treatment regimen with NSAIDs; many MS symptoms do not respond to NSAIDs at all, as they are neuropathic (caused by damage to the nerves themselves) in origin and not caused by prostaglandins.
NSAIDs, though, are successfully and appropriately used by many people with MS to help counter the flu-like side effects of the interferon-based disease-modifying therapies (Avonex, Rebif and Betaseron), reduce swelling from Copaxone-related injection site reactions, counter side effects from other drugs or bring down fevers that tend to worsen MS symptoms or even lead to relapses. Also, let’s face it — most of us get headaches, from time to time, most of which respond to normal doses of NSAIDs. The bottom line here is that it is OK to use NSAIDs if you have MS. Just make sure that they are really appropriate for the problem that you are trying to address and watch for any signs that they may be making your fatigue worse.
But “Fatigue” Isn’t Listed as a Side Effect of My Drug:
Most of the medications listed below have “tiredness” or “drowsiness” as a potential side effect. Some list “dizziness” or “weakness.” Others also have side effects like “sweating,” “trembling,” “difficulty breathing,” “lightheadedness,” “flushing,” “confusion,” “nausea/vomiting” or “fainting spells.” For someone that does not have MS, many of these effects could just be a passing annoyance. For those of us, however, who battle MS-related fatigue on a daily basis, any of the discomforts listed above may be enough to tip the balance between a good day and a bad day, fatiguewise.Note to My Non-U.S. Friends: The list below includes brand names of drugs prescribed in the United States. For people in other countries, please refer to the generic name of the medication, which may be spelled differently depending on the country. Thanks for your understanding.
List of Nonsteroidal Anti-Inflammatory Drugs that May Contribute to Fatigue
Ibuprofen (Motrin, Advil): is a NSAID available as chewable tablets, oral suspension, tablets or capsules. It is also very commonly found as a “store brand” pain reliever.
Acetaminophen (Tylenol, Panadol, Feverall): Used to reduce fever and relieve pain. It is a common ingredient in many nonprescription medications that are designed to treat many symptoms, such as “cold and flu remedies.” It is also very commonly found as a “store brand” pain reliever. It is available as oral suspension or syrup, suppositories, tablets, caplets, chewable tablets or dissolving granules.
Fenoprofen (Nalfon): NSAID often used to relieve mild to moderate pain, including arthritis pain and menstrual pain. It is available as a tablet or capsule.
Ketorolac (Toradol, Acular): NSAID available as eye solution, injections or tablets. It is often used after eye surgery or for eye problems caused by seasonal allergies.
Naproxen (Aleve, Anaprox, Naprelan, Naprosyn): Anti-inflammatory drug available as oral suspension, tablets, caplets or delayed-release tablets.
Tolmetin (Tolectin): NSAID used in rheumatoid arthritis and juvenile arthritis, available as tablets and capsules.
