There is no known cure or way to prevent multiple system atrophy (MSA). There is no specific therapy known to slow the progression of the disease. Rather, treatment is focused on relieving a patient’s symptoms and enhancing a patient’s quality of life.

Various medications are sometimes used to help relieve the symptoms of MSA. Parkinson’s disease medications such as levodopa (a dopamine precursor) and dopamine agonists may help relieve some of the slowness and rigidity associated with MSA. Muscle relaxant medications are sometimes used to treat muscle spasms associated with MSA. Beta blockers may be used to control tremors.

Medications may also be used to help raise the blood pressure of patients with MSA who are experiencing orthostatic hypotension (a significant drop in blood pressure with change in position, such as upon standing). These medications may include vasoconstrictors (drugs that narrow blood vessels, temporarily increasing blood pressure). They may also include medications that help the body retain fluid, raising blood pressure. In some cases, a pacemaker may be surgically implanted to increase a patient’s blood pressure.

Patients are encouraged to consult their physician about which medications and treatment options are appropriate for them.

Certain medications (e.g., Beta blockers) may treat some MSA symptoms (e.g., tremors) but exacerbate others (e.g., low blood pressure). Certain medications may have dangerous side effects (e.g., raising a patient’s blood pressure to dangerous levels when lying down). In addition, the type of MSA a patient has may affect the type of medication chosen. For example, patients with striatonigral degeneration, which involves symptoms similar to those of Parkinson’s disease, may discover their symptoms do not respond to drugs typically used to treat Parkinson’s symptoms (e.g., levodopa).  

Other symptoms of MSA (e.g., impotence, incontinence, constipation) also may be treated with medications.

Self-care methods may help alleviate some symptoms of MSA, such as orthostatic hypotension. Patients who experience a sudden decrease in blood pressure upon standing can wear tight support garments (e.g., pressure stockings) while standing. This improves the flow of blood back to the heart and reduces the risk that blood pressure will drop upon standing. In addition, patients can do the following to reduce the risk of orthostatic hypotension:

• Sleep at a slight incline (head up)
  
  
• Stretch, contract and release muscles in the legs before standing
  
  
• Consume plenty of fluids daily
  
  
• Eat small, frequent meals
  
  
• Increase salt intake (with a physician’s approval)
  
  
• Avoid hot weather, alcohol and dehydration (which can cause blood pressure to drop)

Patients with MSA may benefit from therapy with a speech language pathologist who can help patients improve their ability to swallow or speak. Occupational therapy may help patients regain fine motor skills. A physical therapist can help patients improve muscle tone and strength. Patients may also benefit from psychological counseling to help deal with the stress of having a degenerative disease.

Patients with MSA may eventually require certain devices to assist with movement (e.g., wheelchair). If a patient’s ability to swallow or breath becomes affected, artificial feeding tubes or breathing tubes may become necessary. Arranging for home health care or placement in a healthcare facility may be necessary.