MS News and Notes

LONDON (Reuters) - The popular antidepressant Prozac may help slow multiple sclerosis, according to a Dutch study showing that people who took the drug had fewer of the brain lesions that are a hallmark of the incurable disease.

The findings were from a small study but justified further examination in those afflicted with MS, the researchers reported in one of the British Medical Journal’s specialist journals on Thursday.

“This proof-of-concept study shows that (the drug) tends to reduce the formation of new enhancing lesions in patients with MS,” Jop Mostert, a neurologist at the University Medical Center Groeningen in the Netherlands, and colleagues wrote.

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In researching my column on how small business owners deal with health insurance, I talked to Rosalind Joffe, an executive
coach who specializes in helping people who have chronic illnesses. Ms. Joffe has suffered from multiple sclerosis and ulcerative colitis, both of which have stabilized with treatment — the removal of her colon for the colitis, and the medication, Avonex, for her MS. Prior to getting sick, Ms. Joffe had two successful careers, first as a multimedia producer and then as a professor of communications at Boston University.

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The first pill designed to reduce the number of attacks in people with multiple sclerosis appears to be effective in early tests, Italian researchers report.

The pill was effective in preventing relapses in more than 60 percent of patients who took the pill for three years, according to research that was expected to be presented April 15 the American Academy of Neurology annual meeting, in Chicago.

“All of the current treatments for MS must be injected, so having a pill you can swallow with a glass of water would be a welcome improvement for many people,” lead researcher Dr. Giancarlo Comi, from Vita-Salute San Raffaele University in Milan, said in a prepared statement.

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Todd Small was stuck in quicksand again. It happened, as always, on the floor of the Seattle machine shop where he worked. His shift complete, Small was making the 150-yard walk from his workstation to his car, when he realized that his left leg was sinking deep in the stuff. Though this had happened before — it happened nearly every day now — he stopped and glanced down at his feet. His Nikes looked normal, still firmly planted on the shop’s concrete floor. But he was stuck, just the same. His brain was sending an electrical pulse saying “walk,” but as the signal streaked from his cerebellum and down his spinal cord, it snagged on scar tissue where the myelin layer insulating his nerve fibers had broken down. The message wasn’t getting to his hip flexors or his hamstrings or his left foot. That connection had been severed by his multiple sclerosis. And once again, Small was left with the feeling that, as he described it, “I’m up to my waist in quicksand.”

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What you are about to read is not an endorsement of any particular diet as a therapy for multiple sclerosis. Nor is it a suggestion to forgo established medical treatments.

But so long as it is part of a medically approved treatment program, the diet described here is unlikely to hurt, except perhaps to make meal planning a challenge. And on the testimony of those who have followed it, the plan may be worth trying, despite the lack of scientific evidence to support it.

The diet has not been subjected to a placebo-controlled, randomized clinical trial, the gold standard for determining the value of any therapy. But Ann D. Sawyer and Judith E. Bachrach, co-authors of “The MS Recovery Diet,” say this should not dissuade people struggling with the debilitating symptoms of the degenerative disease.

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When a person is sapped by fatigue, the last thing he or she wants to do is exercise. But new research shows that regular, low-intensity exercise may help boost energy levels in people suffering from fatigue.

Fatigue is one of the most common health symptoms and can be a sign of a variety of medical problems. However, about one in four people suffers from general fatigue not associated with a serious medical condition.

University of Georgia researchers decided to study whether exercise can be used to treat fatigue. The research, which appears in the February issue of the journal Psychotherapy and Psychosomatics, involved 36 volunteers who were not regular exercisers but who complained of persistent fatigue.

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When it comes to understanding, preventing and treating chronic diseases, multiple sclerosis ranks among the most challenging. The word “multiple” is apt in more ways than one.

MS is highly unpredictable. Rarely are any two patients alike in the presentation, duration and progression of symptoms; even the underlying cause of disability in MS is being reconsidered. And rarely do any two patients respond in the same way to a given therapy, be it medically established or alternative. Trial and error is the name of the game, experts say, because it is often not possible to know in advance what will work best for individual patients.

These are the frequent underpinnings of confusion and distrust among those afflicted and their families. They sometimes give rise to claims that the organizations raising large amounts of money to support research and patient services and the scientists studying the disease have no intention of finding a cure, lest it put them out of business. It is a ridiculous notion on its face, since many of those involved in fund-raising and research have watched loved ones suffer and succumb to diseases like MS.

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Multiple sclerosis patients who smoke marijuana in search of symptom relief are more likely to suffer cognitive shortfalls and mood disorders, new Canadian research suggests.A slowing down in the ability to process and remember information is one significant side effect, as is a rise in the rate of depression and anxiety.

“This is a small study, so our findings are preliminary, but the bottom line is that multiple sclerosis patients who smoke cannabis appear to be at an increased risk for cognitive issues, particularly with respect to the speed of their thinking,” said study author Dr. Anthony Feinstein, a professor of psychiatry with the Sunnybrook Health Sciences Centre’s department of psychiatry at the University of Toronto.

Feinstein’s observations are published in the Feb. 13 online edition of Neurology and are focused exclusively on the impact of smoking marijuana illegally obtained by patients themselves. Medically prescribed marijuana was not studied. 

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Two infusions of the cancer drug Rituxan given 2 weeks apart slowed the progression of multiple sclerosis for nearly 1 year, researchers reported on Wednesday.

And Rituxan appears to be twice as effective as first-line treatments for MS, which reduce the number of relapses by about one third, the researchers said.

“It’s quite remarkable that the effect was sustained for 48 weeks with just a single course of therapy,” said Dr. Stephen Hauser of the University of California at San Francisco, who worked on the study published in The New England Journal of Medicine.

Multiple sclerosis, which affects as many as 350,000 people in the United States and 2 million worldwide, is apparently caused when the immune system attacks and breaks down the insulation surrounding cells that make up the brain and spinal cord.

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Almost immediately after a 46-year-old woman with multiple sclerosis received her first dose of the drug Tysabri, a mole that had been on her shoulder for years suddenly took on a dangerous new character.

It turned out to be a melanoma that spread like wildfire. The woman now has just a few months to live.

At almost the same time, a 45-year-old woman who also has multiple sclerosis developed melanoma in her retina after receiving several doses of Tysabri. She had a family history of melanoma and also had atypical moles on her body; the mole on her retina went back at least nine years.

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