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Study Finds that 1 in 4 People with MS Routinely Take 5 or More Medications, Potentially Increasing Health Risks

November 11, 2022

Researchers at the University of British Columbia wanted to know how often people with MS were prescribed multiple medications at the same time. In the general population, taking 5 or more medications (called “polypharmacy”) increases the risk for hospitalization.
  • In addition to MS disease-modifying therapies, many symptoms experienced by people with MS are treatable with various medications and rehabilitation strategies. When multiple medications are taken at the same time, there may be unexpected and harmful health effects.
  • The team examined health claims over one year for more than 14,000 individuals with MS. They found that more than 1 in 4 people were taking 5 or more medications for 30 or more days, and 1 in 20 were taking 10 or more. Most were taking multiple medications for more than 180 days.
  • The most common types of medications contributing to polypharmacy were antidepressants, antiepileptics (for seizures or pain), muscle relaxants, and medications to treat stomach ulcers, acid reflux, and high cholesterol. Many (43%) had also filled at least one prescription for an opioid. Opioids are strong pain medications. When they are used routinely, it can lead to addiction and other negative consequences.
  • Polypharmacy was more common in women, in people who were older, in those who had other medical conditions, and in those from neighborhoods with lower incomes.
  • Polypharmacy is an under-recognized problem in MS. Some previous findings have linked polypharmacy in MS to increased falls, cognitive problems, and fatigue.
 
An accompanying editorial by Drs. Dennis Bourdette and Megan Herink (Oregon Health & Science University) points out the need for more study of this problem, and in the meantime recommends that neurologists:
  • routinely review the effectiveness of the symptom management medications they are prescribing and stop ones that aren’t helping;
  • avoid if possible using more than one medication to control a symptom;
  • use caution prescribing antiepileptics (such as gabapentin and pregabalin) to treat pain;
  • try non-medication approaches such as exercise for fatigue and stretching to treat spasticity;
  • engage with people with MS in a process to reduce unnecessary medications (called deprescribing – www.deprescribing.org).  
 
Polypharmacy and multiple sclerosis: A population-based study,” by Anibal Chertcoff, Huah Shin Ng, Feng Zhu, Yinshan Zhao, and Helen Tremlett, was published online on October 27, 2022 in Multiple Sclerosis Journal. This open-access paper may be read by anyone without the need for a subscription.
 

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system. Symptoms range from numbness and tingling to blindness and paralysis, and there is currently no cure for MS. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. An estimated 1 million people live with MS in the United States. Most people with MS are diagnosed between the ages of 20 and 50, and it affects women three times more than men.

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