Meds for MS: What to Expect

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When we think about MS treatment, I like to think of it as kind of a three-layer cake. Right? So the first layer is when you have that acute symptom that comes on. And you may need steroids for that. Right? But that doesn't affect the immune overactivity. The second layer is disease-modifying therapy where we really try to decrease the activity of the immune system to prevent you from having those attacks.

And then the third layer is symptom management. And that's where we really can affect a person's quality of life. There are some symptoms that we have medications to treat, like numbness and tingling. There are other symptoms like vision loss that we don't necessarily have medications to treat. But we can really improve quality of life in that third layer and in that top layer.

When people start to take disease-modifying therapy, I think it's very important to set clear expectations. It's very contrary to our thinking to take a medication that doesn't make you feel better. But I think that we have to be clear about our goals to decrease relapses, slow progression, and prevent new MRI lesions.

So when some people take their new medication, they may have some of the side effects like an infusion reaction. Or they may have stomach upset. Or they may have flu-like symptoms. But those usually get better the longer you take the medication.

Certainly there are some serious side effects that we want to make sure that we're watching out for. For instance, there are some infections that have occurred with some of the medicines that suppress the immune system. And also, any of them can actually increase your risk for certain infections like upper respiratory infections or urinary tract infections. But you should not expect the symptoms to improve. And so we have to make sure that we're working on the symptom management to help them feel better on a daily basis, but understanding that disease-modifying therapy is for the long term.