Evaluate Your Options

Understand the basics about each option. The drug choices are not simply interchangeable.  Each one has its own variables, so work with your doctor to understand the basics of each option before you make a decision.  Your doctor may strongly recommend a particular option and it may be helpful to you to know why s/he has selected that over the other options.  S/he will consider your medical history to date and the nature of your MS profile and progression in making a recommendation for you.  S/he will also factor in your lifestyle and preferences to help with the decision. Click here to find out "How MS Is Diagnosed".

Understand your needs. Before you review your options, take a minute to consider your lifestyle and personal preferences.  This is important to do because the better a treatment works with your lifestyle and personal needs the more likely you are to stick with it—and the better you stick with it, the more it will help you. A few personal issues that might affect your treatment decision:

  • Frequent Travel.  Some of the medications require refrigeration, which can become complicated with travel, particularly in hot climates and for long stretches of time.  Traveling with needles can also be annoying because of tight security.  So if you travel a lot, you may be more apt to select a medication that will require less frequent injection/administration.
  • Needle Intolerance.  If you really have an issue with needles, you should tell your doctor.  Perhaps a weekly shot would suit you better than a daily one.  Oral options are being tested but not yet available.
  • Organization & routine.  Each medication has its own schedule: daily, weekly, monthly, or a few times a week or year.

Set your expectations—none of these options are cures.  On the other hand, it is important to set realistic expectations about these treatment. To some extent, all of these choices have proven to slow the disease down, reduce the relapse rate, and/or protect the nerves during exacerbations in a way that also reduces the severity and recovery time from them.  If your treatment is effective, it may buy you time or change the course of your disease.  It is hard to know what exacerbations you are preventing by being in treatment.  So even if you still experience problems, presumably they would be more frequent and severe without treatment.

Stick to it.  These treatments need time to work.  A week or a month isn’t likely to tell you much about its efficacy.  Several of the originial trial groups have been followed for more than a decade and shown an increasing effectiveness over time.  Treatment is a commitment.  You’ll get the most out of it by sticking to the schedule.  Skipping doses and getting sloppy with your schedule will reduce its effectiveness.

Flag any problems.  As with any drugs, there is always a list of possible side effects.  In some cases, it may be flu like symptoms, in others it may just be minor pain at the injection site.  Sometimes allergic reactions are possible.  If you experience any troubling or unexpected side effects, call your doctor immediately

Re-evaluate.  So how will you know if it’s working?  To make that evaluation, your doctors will be looking at your:

  • MRIs over time.  Since the body can heal, it is possible to see an improvement in your MRIs over time.  Doctors will be looking to see if the number of lesions stays the same or decreases, as well as noting the changes in the size of lesions.
  • Relapse rate.  The relapse rate suggests how active your MS is.  If you were having an exacerbation every year and now you’ve gone two years without one, then you’re making progress.

Changes in physical exam.  At each visit, your doctor will check a variety of physical indicators to see if there is any progression in the disease.  These will include looking at your eyes and checking strength, reflexes, and coordination.