For relapsing forms of MS, there are a variety of disease-modifying medications that can help slow the course of MS. There are 2 important things to expect from your treatment with a disease-modifying medication:
1. Your treatment should effectively slow the progression of your disease.
The earlier you receive optimal treatment, the better. Researchers believe that there may be a "window of opportunity" early in the disease where treatment has the maximum impact on slowing down the progression of MS. If you wait too long to be treated or spend too long on a treatment that isn't working, you could miss this window.
Since being on the most appropriate treatment early in your disease is very important, you may want to ask your neurologist to check whether your treatment is helping you with the following 4 key areas:
- Disability progression: MS can cause a person to become disabled because it can lead to poor coordination and balance, weakness, muscle stiffness or spasticity, vision changes, or problems with thinking and memory. The Expanded Disability Status Scale (EDSS) is often used by doctors to rank a patient's degree of disability on a scale of 0 to 10, with lower numbers meaning less severe disability.
- Relapse rate: With relapsing forms of MS, people experience "relapses," which are periods of time where symptoms suddenly get worse or new symptoms suddenly appear. The more relapses you have in the first 2 years of the disease, the greater your risk of disability later on. Even one relapse in the first 2 years increases your risk of faster progression.
- Brain lesions on MRI: An MRI (magnetic resonance imaging) scan is used to give neurologists a picture of a person's brain, which can help them look for brain lesions (areas of the brain that have been damaged by MS). MS can be active even when you are not having a relapse, and brain lesions are one way to measure this disease activity.
- Brain changes: As a person ages, it is quite normal for the brain to shrink. However, with MS it can happen much more quickly than usual. Brain changes can be seen on an MRI scan. They are related to cognitive problems (problems with thinking, memory, or planning) associated with MS.
2. Your treatment should fit into your lifestyle. To make sure you are using the most appropriate treatment for you, ask yourself:
- Do I sometimes find it hard to use my treatment?
- Do I sometimes get tired of using my treatment?
- Do I sometimes not use my treatment as directed by my doctor?
- Do I have side effects from my treatment that are hard to tolerate?
- Do I sometimes forget to take my treatment?
If the answer to any of these questions is "yes," it's time to discuss treatment with your neurologist.
If the idea of discussing your treatment with your neurologist makes you nervous, read Taking charge of your treatment to learn how to advocate for yourself and discuss treatment with your neurologist.