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Multiple Sclerosis Treatment: Set Realistic Expectations for DMTs

To help you maintain control of your multiple sclerosis (MS), your doctor may recommend a medication that have been shown to slow or modify the disease course (known as disease-modifying therapies or DMTs for short).

One of the keys to success with the DMTs is knowing what you can reasonably expect from them, and what you can’t. So here it goes:

  • These medications aren’t cures for MS, and they aren’t designed to relieve existing symptoms or make you feel better (although some people do feel better if their MS has been very active, with lots of uncomfortable relapses).

  • When effective, these medications can help reduce the number and severity of relapses and decrease the numbers of new lesions that appear on your MRI scan. And they may slow disease progression and the accumulation of disabling symptoms.

  • With these medications, you’re still likely to experience a relapse every now and then, and you’ll probably find new lesions on the MRI (although not as many new ones as before). You may also still have a lot of the same old symptoms.

The fact is that on a day-to-day basis you aren’t going to know whether the medication you’re taking is actually “working” for you. Because the goal of the disease-modifying medications is to slow disease activity, you and your doctor will determine the effectiveness of your treatment by tracking your relapses, keeping an eye on your symptoms, and perhaps repeating your MRI scans periodically to see what’s going on in your CNS.

You’re taking a DMT based on the assumption that the medication will do for you what it did for the people in the clinical trials that evaluated it — which is to modify the disease by reducing the number and frequency of relapses and reducing new areas of inflammation in the CNS.

By keeping your expectations realistic, you’ll be able to stick with the program no matter what medication you’re on. In the event that your physician determines that the treatment isn’t helping sufficiently to slow your disease, he or she will suggest trying another one of the medications to see if it does the trick. And new treatments and treatment combinations are being studied all the time, so you and your doctor will have more options from which to choose.

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