This text provides general information and is no substitute for medical advice. Diagnosis and treatment belong in the hands of neurologists; never stop prescribed medication on your own. Rules, approvals and guidelines differ from country to country; sources marked (German) refer to Germany.
1. Relapse treatment
For a relapse with noticeable impairment, a high-dose glucocorticoid (cortisone) is usually given over a few days. If that is not enough, blood-cleansing procedures such as plasma exchange or immunoadsorption may be considered.
2. Disease-modifying therapies
These drugs reduce the number of relapses and new lesions on MRI and can delay progression. The German guideline distinguishes by disease activity:
- Substances for milder courses, for example interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate.
- Substances for active courses, for example S1P receptor modulators (such as fingolimod), cladribine, natalizumab and anti-CD20 antibodies (such as ocrelizumab, ofatumumab).
The choice depends on disease activity, disease course, other conditions, plans for a family and your own wishes, among other things. Each substance has its own side effects and monitoring. For primary progressive MS there are fewer approved options. New substances, such as BTK inhibitors, are being studied; we put current results in context under Studies & research.
Which drugs are approved and reimbursed differs from country to country, and so do the guidelines. The overview here follows the German guideline; check the situation in your country with your neurologist.
3. Symptomatic therapy and rehabilitation
Many complaints can be treated independently of the disease course: spasticity, bladder problems, pain, fatigue or depression. This includes medication, physiotherapy, occupational therapy, speech therapy, neuropsychology and rehabilitation. Regular exercise (in German) and a balanced diet (in German) are part of a good daily life with MS.
Frequently asked questions
Which MS therapy is the best?
That depends on the disease course and on personal circumstances. The choice is made together with your neurologist.
When should treatment start?
According to the guidelines, as early as possible, once the diagnosis is confirmed and there is disease activity.
Can you stop the therapy?
Only after talking to your doctor. Stopping on your own can lead to renewed disease activity.
Sources
- DGN/AWMF guideline (German): diagnosis and treatment of multiple sclerosis, neuromyelitis optica spectrum disorders and MOG-IgG-associated diseases (030-050)
- Deutsche Multiple Sklerose Gesellschaft (DMSG), federal association (German)
As of: 2026-11-02. More basics: What is multiple sclerosis (MS)? · MS symptoms: early signs and typical complaints · MS diagnosis: how multiple sclerosis is established.