Probably the
most common problems people who suffer
from Multiple Sclerosis (MS) face on a
daily basis are weakness and fatigue.
Also. many patients are faced with
visual problems and with cognitive or
concentration effects. Very few of the
standard treatments have much effect on
these situations. However, clinical
research has shown that many patients
can benefit from a little-known
medication, 4-Aminopyridine (4AP).
What is
4-aminopyridine?
4-Aminopyridine (4-AP) is known as a
“potassium channel blocker”. This means
that it can block the flow of potassium
ions in nerve cells, which results in a
more effective nerve impulse traveling
down toward the muscles. As you probably
know, the poor nerve impulses in
patients with MS is the cause of most of
the symptoms of the disease. The
improved nerve conduction provided by
the 4-AP means that the muscles have a
"louder signal” to tell them when to
work and the stronger muscle
contractions improve strength and
fatigue in many patients. However for
reasons not fully understood, the 4AP
does not work in all patients. One study
indicates that 75% of patients with MS
report a significant clinical response,
and that 80% to 90% of these people will
benefit from long-term administration of
the medication. Other studies report a
lower response rate, around 30% to 50%.
A related compound, 3-4 diaminopyridine.
is used in another neurological disease
known as Lambert-Eaton Syndrome. It is
not commonly used in Multiple Sclerosis
Why has my
doctor not told me of this option?
4-AP is not
a patentable medication, since it was
discovered many years before its effects
on MS were known. Many doctors are aware
of its existence, but are not aware that
it is available. The medication is
available as the raw ingredient, and a
compounding pharmacy can put it into
capsules based on the dosage determined
by weight of the patient and the
response to 4-AP. Some doctors prefer to
use an immediate release capsule
exclusively, while others will change
their patients to a sustained release
form after a person’s correct dosage is
determined. The sustained release form
offers more convenient dosing. and can
minimize any possible side effects.
What kind of
side effects can occur?
Patients
report that side effects are usually
minor, and include parenthesis (usually
tingling sensations around the face) and
occasional stomach problems. The most
serious side effect is
seizures, which is a dose-related
problem. For this reason the dosage is
tailored to each individual and the
person’s maximum dose should never be
exceeded.
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provide or confirm a diagnosis.
