How MS Treatments Work: Provigil, Ampyra, & Baclofen

When you have MS, you’re likely to learn about a whole slew of treatment options, either mentioned by your doctor or from your own research. There usually isn’t a great explanation of what they are and how they work, so I am hoping to explain some of them in a more digestible manner.

Medication for MS symptoms

Not long ago, I took a look at a few of the popular disease-modifying treatments for multiple sclerosis. I thought I’d try that again, however, this time I’m going to look at a few common medications used to treat symptoms of MS. Today, let’s take a look at Provigil, Ampyra, and Baclofen.

Provigil (Modafinil)

Modafinil, commonly known by the brand name Provigil, is a medication (taken via tablet) designed to promote wakefulness in people who suffer from narcolepsy, obstructive sleep apnea, and shift work disorder. It has also been seeing widespread use for those with multiple sclerosis to help them battle the symptom of fatigue.1

As can often be the case, the exact reasons why modafinil works aren’t fully understood, however, there is some thought that it helps increase levels of dopamine (which your nervous system uses to send messages between nerve cells). To put it simply, we know modafinil changes the amounts of several naturally produced substances in the part of our brain responsible for sleep and wakefulness. Changing these amounts makes us stay awake better.1  You can read about my own experience with Provigil here.

Dalfampridine (Ampyra)

Ampyra is a medication (taken via tablet) that is prescribed to increase the walking speed of MS patients.2 It works by blocking tiny pores, called potassium channels, on the surface of nerve fibers. When a nerve has had its myelin damaged because of multiple sclerosis, blocking these potassium channels can help improve how signals move along those damaged nerves.3

Think of a wave coming in from the ocean, now imagine you’ve dug a few small holes on the beach between you and the ocean, well, that wave will reach you faster and more intact if those holes were filled in right? Otherwise, as the wave is coming to you, parts of it will get interrupted by those holes. Ampyra aims to improve the conduction of nerve signals along damaged nerves. It looks to fill in those holes so the wave can get to you faster.3

I have tried Ampyra several times over the course of my life with MS, but it has not been effective for me. It does help many people though, and we can tangibly see that because when Ampyra is prescribed, patients have their walking speed monitored to verify if it is effective or not.

Baclofen (Lioresal)

If you have multiple sclerosis, you’ve probably heard of Baclofen (taken via tablet, liquid, or a pump that delivers it to the spinal cord). It remains one of the most commonly prescribed medications to combat the symptom of spasticity. With everything MS-related, spasticity is caused by damage to the insulation around our nerves. Signals being sent from our brain and spinal cord to control muscles often have these signals interrupted, which causes our muscles to work when we don’t want them to and vice versa.

Baclofen is a muscle relaxant and works by limiting the number of messages sent between certain nerve cells, thereby decreasing how often muscles expand and contract. In doing this, it lessens the amount and severity of spasms.4 Baclofen has been around for a long time, even my grandfather who had MS was able to benefit from it. While it helped my spasticity, it impacted my already decreased ability to feel energetic. This was one of those rare cases for me where the side effects were too much for me. It happens, that’s why we try things. I know a lot of people who have been helped by this medication though.

Thanks so much for reading and always feel free to share! As always, I would love to hear about your experiences in the comments below!

Devin

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