Topic Overview

Pain is a frequent problem for people who have multiple sclerosis (MS). Medicines that may be used to bring relief include:

• Nonprescription pain relievers. These include acetaminophen (such as Tylenol), ibuprofen (such as Advil), and naproxen (such as Aleve).
• Baclofen (Lioresal).
• Carbamazepine (Tegretol).
• Phenytoin (Dilantin).
• Gabapentin (Neurontin). This drug may also help relieve muscle stiffness and tightness (spasticity).
• Diazepam (Valium).
• Pimozide (Orap), which is effective against facial pain and tics but can produce lethargy and trembling.
• Amitriptyline, imipramine (Tofranil), or nortriptyline (Pamelor), for burning sensations.

Antiseizure medicines (such as carbamazepine or phenytoin) are sometimes combined with antispasticity medicines (such as gabapentin) to help relieve pain.

Pain that does not respond to these medicines can sometimes be treated with an injection of long-acting anesthetic or radiation therapy.

The U.S. Food and Drug Administration (FDA) has issued a warning on antiseizure medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take antiseizure medicine should be watched closely for warning signs of suicide. People who take antiseizure medicine and who are worried about this side effect should talk to a doctor.