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Polypharmacy in Multiple Sclerosis: Prevalence, Risks, and Mitigation Strategies

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Abstract 

Purpose of Review

Polypharmacy, the use of ≥ 5 medications, is common in people with multiple sclerosis and is associated with negative outcomes. The use of multiple medications is common for symptom management in people with multiple sclerosis, but risks drug-drug interactions and additive side effects. Multiple sclerosis providers should therefore focus on the appropriateness and risks versus benefits of pharmacotherapy in each patient. This review describes the prevalence and risks associated with polypharmacy in people with multiple sclerosis and offers strategies to identify and mitigate inappropriate polypharmacy.

Recent Findings

Research in people with multiple sclerosis has identified risk factors and negative outcomes associated with polypharmacy. Medication class-specific investigations highlight their contribution to potentially inappropriate polypharmacy in people with multiple sclerosis.

Summary

People with multiple sclerosis are at risk for inappropriate polypharmacy. Multiple sclerosis providers should review medications and consider their appropriateness and potential for deprescribing within the context of each patient.

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Acknowledgements

This investigation was supported in part by an Institutional Clinician Training Award from the National Multiple Sclerosis Society.

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Author notes

  1. W. Daniel Chapman and Megan C. Herink have contributed equally to this paper.

Authors and Affiliations

  1. Department of Neurology, Oregon Health & Science University, Portland, OR, USA

    W. Daniel Chapman & Dennis Bourdette

  2. College of Pharmacy, Oregon Health & Science University/Oregon State University, Portland, OR, USA

    Megan C. Herink

  3. Department of Neurology, Oregon Health & Science University and VA Portland Health Care System, Portland, OR, USA

    Michelle H. Cameron

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Correspondence to W. Daniel Chapman.

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Chapman, W.D., Herink, M.C., Cameron, M.H. et al. Polypharmacy in Multiple Sclerosis: Prevalence, Risks, and Mitigation Strategies. Curr Neurol Neurosci Rep 23, 521–529 (2023). https://doi.org/10.1007/s11910-023-01289-9

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