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.Medications for Tremor in Multiple Sclerosis
The two primary types of tremor in MS are intention tremor and postural tremor. Unfortunately, even though different medications have been tried, MS-related tremor is very difficult to treat with drugs, as the side effects (such as fatigue) usually seem to outweigh the benefits for most people. Some people, though, report success with these medications, because they may have a higher tolerance for the side effects, are so bothered by the tremor that any benefit is considered “worth it” or are just one of those lucky people for whom the medication was simply a good fit. For those who are not helped by medications, other interventions, such as physical therapy or surgery, may be options.Also, don’t be shocked if you find out that your drug was originally created to be an antibiotic or treat heart problems – many drugs have a wide range of uses.
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, such as “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 who battle MS-related fatigue on a daily basis, though, 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.
Medications for Intention Tremor in Multiple Sclerosis
By far the most common type of tremor in MS, intention tremor (also called "cerebellar tremor") occurs when you reach for something and your hand starts shaking. The closer you get to your target or the smaller the movement required, the more your hand or arm will shake. It is the most difficult to treat successfully. The drugs below have been shown to have limited success in some people.Isoniazid (Nydrazid): Is an antibiotic used to treat tuberuculosis, available as an injection, oral syrup or tablets. It should be noted that elderly patients are more likely to experience side effects.
Ondansetron (Zofran): An antinausea drug, available as an injection, oral solution or tablets.
Propranolol (Inderal): A beta-blocker used to calm arrhythmia (erratic heartbeat), available as an injection, oral solution, tablets or extended-release capsules.
Primidone (Mysoline): A drug which is chemically similar to a barbituate and is used to control epileptic seizures or convulsions. It is available as oral suspension, tablets or chewable tablets.
Cannibis (Marijuana, Sativex): Considered an illegal substance in most parts of the United States, it is approved in other countries as an antinausea medication (Sativex) to treat neuropathic pain in multiple sclerosis.
Medications for Postural Tremor in Multiple Sclerosis
Postural tremor is a shaking that occurs while you are sitting or standing and your muscles are trying to hold parts of your body still against the force of gravity.Clonazepam (Klonopin): A benzodiazepine, available as orally disintegrating tablets (wafer) or tablets.
Gabapentin (Neurontin): An anticonvulsant, available as capsules, tablets or oral solution.
Primidone (Mysoline): A barbituate used to control epileptic seizures or convulsions, available as oral suspension, tablets or chewable tablets.
Acetazolamide (Diamox): Used to treat glaucoma and some types of seizures, available as an injection, sustained-release capsules or tablets.
Medications for Rest Tremor
This describes shaking in a body part that is not voluntarily moved and is completely supported against gravity, such as that seen in Parkinson’s disease. In general, this type of tremor is NOT a symptom of MS. It is possible, though, that some people may have been prescribed the following drugs before receiving an MS diagnosis. If you have MS and are taking one of these medications, this should be revisited with your physician.Levodopa (Larodopa): Used to treat Parkinson’s disease
Carbidopa (Lodosyn): Carbidopa is always given with levodopa (e.g., Dopar or Laridopa) or carbidopa-levodopa combination products (e.g., Sinemet), in order to increase the benefits and reduce side effects of levodopa.
