The two main SSNRIs that are prescribed for people with MS-related anxiety are: Venlafaxine (Effexor) — Also treats hot flashes in postmenopausal women. Duloxetine (Cymbalta) — Also treats neuropathic pain.
For some, an antidepressant, such as certain SSRIs that work on depressive and anxious symptoms, is indicated. Examples include Celexa® (citalopram) or Lexapro® (escitalopram). Additionally, Effexor® (venlafaxine) or Cymbalta® (duloxetine hydrochloride) may also be considered.
Addressing MS-Related Anxiety
Another avenue is acceptance and commitment therapy (ACT). “We identify what is most valuable to a person and then find a way to pursue that value despite their MS symptoms,” says Beier. Talk therapy and medications help address specific causes of anxiety.
People with MS who also have fatigue might benefit from bupropion (Wellbutrin), an atypical antidepressant. The drug is called atypical because it works differently from other types of antidepressants, like SSRIs and SNRIs. Some MyMSTeam members find that other antidepressants may worsen fatigue.
MS can cause significant anxiety, distress, anger, and frustration from the moment of its very first symptoms. The uncertainty and unpredictability associated with MS is one of its most distressing aspects. In fact, anxiety is at least as common in MS as depression.
Anxiety is also common among people with MS, notes the NMSS. Anxiety can be caused by the uncertainty and unpredictability of living with MS, loss of function, and changes to life circumstances. Among people who are newly diagnosed, lack of knowledge about MS can also contribute to anxiety.
Prevalence of anxiety in MS
Anxiety is prevalent in MS at 36% (95% CI = [0.30–0.42], I2 = 98.4%, p < 0.001; 32 studies).
For primary-progressive MS , ocrelizumab (Ocrevus) is the only FDA-approved disease-modifying therapy (DMT). Those who receive this treatment are slightly less likely to progress than those who are untreated.
Ocrevus and Tysabri account for over 85% of the patient share of multiple sclerosis medications. Ocrevus experienced a 5.6% year-over-year (YoY) growth, while all other top 10 medications experienced less than a 1.8% YoY change in variance.
Drugs for Fatigue
Some common options used for MS include: Amantadine (Gocovri, Symmetrel).
Never Self-Diagnose MS From Anxiety
Unfortunately, anxiety causes many of the same symptoms as the early stages of MS. MS is one of the health issues that comes up most when those with anxiety search for their symptoms online, and millions of those with anxiety convince themselves that they might have MS.
Other medications are used to speed recovery from an MS attack. Some of the medications that a doctor might prescribe for relapses or attacks of MS include: A 3-to-5-day course of corticosteroids to treat inflammation and reduce the duration of the attack.
Diazepam is a muscle relaxant that can reduce stiffness and spasms. Because of side effects at higher doses, it may be more useful at night. Diazepam is no longer widely used to treat MS spasms and stiffness, but can help some people if other treatments have not worked.
Diazepam is a benzodiazepine that belongs to the group of medicines called central nervous system (CNS) depressants, which slow down the nervous system. Although diazepam is used for a variety of medical conditions, it is used in multiple sclerosis primarily for the relief of muscle spasms and spasticity.
Glatiramer acetate (Copaxone, Glatopa) Interferon beta-1a (Avonex, Rebif ) Interferon beta-1b (Betaseron) Mitoxantrone (Novantrone)
On December 28, 2022, the U.S. Food and Drug Administration (FDA) approved Briumvi (ublituximab), a disease-modifying therapy (DMT) to treat relapsing forms of multiple sclerosis (RMS) in adults, including clinically isolated syndrome, relapsing-remitting MS, and active secondary-progressive MS.
THE DRUG: Teriflunomide (Aubagio)
Dosage: A daily pill. Side effects: Liver damage, but the risk is lower than with the interferons and does not require such close monitoring. Compared with other drugs, its risk of side effects—especially severe ones—is among the lowest.
Results revealed that major life events (e.g., divorce, conflicts, sickness, and accidents) increased MS risk by 15% to 30%. 4. In another study, individuals exposed to any stressful life event during childhood were found to have an 11% increased risk of MS compared to individuals not exposed to childhood stress.
Depression can occur throughout the course of MS, even in mild forms of the disease [11], and has a reported higher risk of depression in the first years after the diagnosis [12]. Disease activity, but not its duration, was associated with depression and anxiety [13].
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system. Studies have shown that MS disrupts several social cognitive abilities [including empathy and theory of mind (ToM)].
Living with the symptoms of MS can be very draining, both physically and emotionally. Fatigue, pain, depression and anxiety can leave you feeling very fragile. If you're not sleeping well, or are feeling under pressure, that can make things seem even more difficult.
Factors that may trigger MS include: Exposure to certain viruses or bacteria: Some research suggests that being exposed to certain infections (such as Epstein-Barr virus) can trigger MS later in life. Where you live: Your environment may play a role in your risk for developing MS.