Multiple Sclerosis Health Center

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The National MS Society also says that treatment with medicine may be considered after the first attack in some people who are at a high risk for MS (before MS is definitely diagnosed).⁴

Despite the recommendation, some people find it hard to decide whether to begin disease-modifying therapy, especially when their symptoms have been fairly mild. Some may not want to bear the risks and side effects of medicine when they are not sure they need it. Some may want to see whether their disease gets worse before they start therapy. A small percentage of people diagnosed with MS may never have more than a few mild episodes and may never develop any disability, but the disease is unpredictable. For more information, see:

Multiple Sclerosis: Should I Start Taking Medicines for MS?

If you decide not to try disease-modifying therapy at this time, work with your doctor to monitor your health through regular checkups and periodic MRI scans to evaluate whether the disease is progressing. If new lesions are developing or existing lesions are growing, you may want to reconsider your decision and begin treatment.

Treating symptoms and relapses

The need and desire for medicine vary. If your symptoms are mild, you may choose to manage them without any medicine. If you have specific symptoms that are causing problems, certain medicines may help you keep them under control. Or you may want to use medicine only during a relapse.

You may also want to think about:

• The possible side effects of using steroids or other medicines to treat symptoms or control a relapse. Some people have only minor side effects. But others may have side effects that concern them more than their MS symptoms.
• The costs of treating symptoms and controlling relapses. In some cases, using medicine to control symptoms and relapses may reduce the need for hospital stays.
• Other personal issues that you face at work or at home.

Also keep in mind that it can be hard to tell whether medicine is helping. Multiple sclerosis is a disease with spontaneous remissions, which means that your condition can improve on its own, without any treatment. Just because your symptoms improve after treatment does not mean that a treatment is working.