Treatment and management of MSA – an overview
This overview has been produced by the Multiple System Atrophy Trust for sharing with people with MSA, their carers and family members. The Trust is happy for it to be widely circulated. Further information can be found on the Trust’s website (www.msatrust.org.uk) or from the Trust’s office at Southbank House, Black Prince Road, London SE1 7SJ. The Trust has specialist MSA nurses as well as regional and online support groups. Please call 020 7940 4666 for more details.
Treatment for patients with MSA involves a combination of medication, specialised equipment and the use of therapists to manage individual symptoms. The list below shows members of a multidisciplinary team which may be involved in their care in conjunction with them and their GP:
- MSA TRUST & SPECIALIST NURSES
- PARKINSON’S DISEASE NURSE SPECIALIST
- PALLIATIVE CARE SPECIALISTS
- GENERAL PRACTITIONER
- CONTINENCE ADVISOR
- COMMUNITY NURSES
- OCCUPATIONAL THERAPIST
- SPEECH AND LANGUAGE THERAPIST
- CARER SUPPORT
- SOCIAL WORKER
The complex nature of MSA means that the best treatment is gained from a multidisciplinary team approach, involving a group of health and social care professionals.
Ideally you will be supported by your GP who will act as a care coordinator and refer you to other members of the multidisciplinary team. It is quite possible your GP has not previously seen a patient with MSA but the Trust can provide specific medical information to your doctor. Likewise members of the multidisciplinary team may not have treated anyone with MSA but don’t be discouraged by this. Ask them to contact the Trust for information and advice.
What medication can I take?
Medication regimes will vary depending on your symptoms. Medications are very individual and what works for one person may not be effective for another. Your specialist will prescribe the best combination to meet your needs. Here are some of the medications commonly used in MSA.
Drugs to help stiffness and slowness are the same drugs used in Parkinson’s disease (PD). They are often not as effective in MSA and can make blood pressure problems worse. It may take time to find what suits you and if a medication is not useful it can be reduced or discontinued on the advice of your specialist.
- L-Dopa (Madopar or Sinemet)
- Amantadine (Symmetrel)
Physiotherapy can also prove useful with tips to get you moving. This is important as inactivity may worsen the problem.
Feeling unsafe on stairs may be due to problems with balance and people often feel they need to use furniture for support. Physiotherapists and occupational therapists can provide advice and equipment to help you move safely.