Treatment for MSA
Treating MSA is difficult because it is not responsive to levodopa therapy (the treatment of choice for Parkinson's disease). In some cases, levodopa may have some benefit early in the course of the disease, but the response is generally short-lived.
Physical, occupational, and speech therapy have all proven helpful for maintaining mobility in the early stages of Parkinson's and they may be helpful in treating MSA as well.
Other medications may be used to alleviate particular symptoms, such as the orthostatic hypotension or urinary incontinence of Shy-Drager syndrome.
In February 2014, the U.S. Food and Drug Administration (FDA) approved droxidopa (Northera capsules) to treat neurogenic orthostatic hypotension. This medication carries a boxed warning cautioning patients and health care providers that it may increase the risk for high blood pressure while lying down (called supine hypertension), which can cause stroke. Droxidopa was approved under the FDA's accelerated approval program, and additional research and post-approval clinical trials are required. Side effects include headache, nausea, fatigue, and others.
Please contact the National Institute of Neurological Disorders and Stroke for more information and resources on multiple system atrophy.