Changing Treatments for Multiple Sclerosis: When Is It Necessary?

You might switch if your MS medicine isn’t working well enough — or not working at all.

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Doctors know that many of their patients find it inconvenient or time-consuming to visit their offices. But when you are managing multiple sclerosis symptoms, frequent visits to your doctor comes with the territory. This can help you monitor your progress and evaluate your treatment plan.

“I usually tell patients that they're not married to one specific medication and that people can switch,” says Asaff Harel, MD, Neurologist at Lenox Hill Hospital, Northwell Health. “So if there are issues, if there are side effects, it is really, really important to bring that to your doctor, so that appropriate steps can be taken.”

What are common reasons to change treatments for multiple sclerosis?

Dr. Harel outlines the most common reasons someone might change their MS medication:

1. Your medicine isn’t working well enough — or not working at all.

“It’s what I [refer] to as incomplete effectiveness,” says Dr. Harel. “The medication may not be effective enough, or not as much as we'd like, and we can do better in this modern era by escalating therapies.” 

Keep in mind that it may take several months before you can know for sure if a medication is working for you.

2. Your medicine is causing side effects that you get in the way of your life.

“One of the other potential common reasons for switching is tolerability issues,” says Dr. Harel. “If there are side effects that impact somebody's day to day, that may be a reason to switch therapies.”

3. Your medicine is having negative effects on your health.

“Then finally, if there's a safety concern,” says Dr. Harel. “If there's something that your doctor sees in your blood work, for example, that raises safety issues, that may be a reason to switch therapy options.”

4. The medicine doesn’t work with your lifestyle, schedule, or preferences.

“If somebody's having, for example, difficulty remembering pills or injections, they may bring that to their doctor and have a discussion about other options for therapies,” says Dr. Harel. “If the current therapy doesn't really agree with their current lifestyle, [such as] if they have either a busy schedule or they're traveling a lot, they may not be able to come in for infusions.”

Be honest with your care team about how your current treatment is (or isn’t) working

When your treatment isn’t working, you might fall prone to hopelessness, isolation, and even depression. It doesn’t have to be this way. Tell your loved ones what you need from them in order to help you stay the course while you try out different options.

“I always remind patients that this is a team effort — [I] really encourage my patients to come over and discuss any concerns that they have about medications, any side effects that they may be having, anything like that,” says Dr. Harel. “It really requires an open dialogue.”