There are a number of medications used to treat MS, some more common than others. Get answers about taking medication, side effects, benefits and more.
Dr Jonathan White talks through what people with multiple sclerosis should expect when using a private doctor for a B12 injection.
When considering the use of a disease-modifying drug (DMD), there are various factors that someone with MS should consider, including:
When should I start?
Should I start medication straight after diagnosis, on the basis that the earlier I start, the better the potential long-term outcome, or can I hold off and implement lifestyle changes to see how well I can manage my own MS?
Which one should I take?
There are an ever increasing number of DMDs. The ones on offer by your MS team may reflect their availability in your area, and on their suitability for your individual MS
What benefits can I expect?
All DMDs aim to reduce the frequency and severity of relapses, and some of the newer generation also have greater evidence for reduction in disability progression over time. What are the risks and potential side effects? Generally speaking, the more effective an MS drug, the greater the risk of serious side effects, but each DMD has a different side effect profile.. Some of these are potentially very severe, and must be discussed with your MS team before starting any treatment.
How will it fit into my lifestyle?
Some treatments are self-injectables that need to be refrigerated, others require you to attend the hospital or treatment centre for infusions at time periods ranging from every 4 months to 6 or 12 months.
How will this fit with your lifestyle, your work, your ability to travel to and from treatments?
What monitoring will I need?
Almost every DMD requires regular blood monitoring, ranging form every 4 weeks to every 3 months while on treatment. In the modern treatment era, your MS team will likely want you to undergo an MRI scan regularly, to ensure that the treatment is working, and to recognise potential complications of treatment at an early stage.
What about starting a family?
Over time, doctors are realising that many of the DMDs are safer in pregnancy that previously thought. But some must be stopped before trying to conceive of female e.g. fingolimod, teriflunomide, cladribine, and need different wash-out periods. In men, the only DMD to be aware of if trying to conceive is cladribine, which can affect sperm for 6 months from its last dose
Interferons are proteins which are naturally made by the body to reduce inflammation and to fight viral infections. However, people with MS can also take man-made interferons - this is done with an injection pen with variable frequency. Interferon treatment is less effective than some of the newer DMDs, reducing relapse rates by about a third, with a relatively modest effect on long-term on disability progression, but the side-effects can be unpleasant and even debilitating.
The safety of stopping any disease-modifying drug (DMD) safely is different in every individual case, so this decision should not be taken without medical advice. There is limited scientific research into this topic, but one study found that younger people have a higher risk of returning MS activity when stopping DMDs than older people with MS.
This video demonstration below was performed at one of the Gawler MS Retreats and shows the correct technique:
In this video, Dr Jonathan White talks about Copaxone, other disease-modifying drugs and how to stop them. Jonathan has also answered a series of other frequently-asked questions, which you can see here.