Why Take a Medicine if you Feel Fine?
I just met with a lovely young lady who was diagnosed with MS in 2001. She took one of the interferon medications for 5 years and did very well on it, having few, if any, relapses. She found the medication intolerable, however, and stopped it for 3 years. During this time, she did not take any medications or see any doctors. This symptom free period lasted until a few weeks ago when she had an unfortunate bout of optic neuritis.
I told the patient I understood why she stopped taking the medicine. After all, for her, the cure was worse than the disease. But I did not understand why she stopped seeing doctors altogether. She told me that she sought no medical treatment, “because I felt fine.”
This is one of the most common statements that I hear from patients with MS, especially early in the course of the illness. And I am certainly happy to hear it. Why would I want my patients to say anything else? However, I am always distressed when patients use this as a reason to stop taking their medications, especially when tolerable alternatives almost always can be found. After all, the point of these medications is to help ensure that people who feel fine continue to feel that way.
For many people starting a medication for MS, the idea that this medication will not make them feel better (and often makes them feel worse) is often quite counterintuitive. Newly diagnosed patients are almost always otherwise healthy, active people, and in the past have taken only medicine that is supposed to make them feel better, such as pain relievers or antibiotics.
However the idea of taking a medicine to prevent a bad outcome is very common in medicine. No one comes to their doctor saying that their blood pressure or high cholesterol hurts them. Yet medicines to treat these conditions are amongst the most prescribed medications in the country with the hope of preventing, or at least forestalling, heart attack or stroke.
The treatments for MS are no different in that they are designed to prevent or delay bad things from happening. So whenever I meet a patient who tells me that they started on a medication for MS but stopped it because they did not feel any better, I know that this person is confused about what these medications are designed to do. It is the responsibility of the prescribing doctor to manage the patients’ expectations and properly explain the medication’s purpose. Hopefully, an accurate understanding of the medications for MS will lead to more people taking them properly.
I am available via e-mail at firstname.lastname@example.org and will try to answer all questions.