Relapsing-remitting multiple sclerosis (RRMS) is the most common form of multiple sclerosis (MS).
You may have periods when symptoms either don’t progress or don’t occur at all (remission) followed by bouts of worsening symptoms or brand-new symptoms (relapse).
During remission, sometimes the symptoms that remain become permanent.
Over time, inflammation will affect the central nervous system of people with MS. This makes symptoms and overall disease progression difficult to predict.
With RRMS, symptoms may worsen over time. Subsequently, your treatment plan may require modification.
If you’re having new symptoms, you may be thinking about switching your medications. While switching RRMS medications might be helpful, the transition won’t necessarily be a smooth one. Talking with your doctor can help.
Before you stop your current treatment plan and start up another one, be sure to discuss safety considerations, effectiveness, and the possibility of side effects with your doctor. You’ll also need to understand all dosing information.
MS medications are also known as disease-modifying therapies (DMTs). The primary goal of DMTs is to help prevent new lesions and new symptoms from occurring. They also help slow disease progression.
The Cleveland Clinic recommends changing your DMT if:
- Your medication causes intolerable side effects.
- Your RRMS has gotten worse.
- You’re pregnant or trying to conceive.
- You can no longer afford your medication.
- The medication’s treatment schedule isn’t working for you.
Your symptoms can also indicate whether or not your DMT is working properly. Common symptoms of RRMS include:
- blurry or double vision
- changes in memory
- weakness in the arms or legs
- difficulty walking
If you’re already on medication and experience the above symptoms in a new or worsening fashion, then it’s time to consider a new DMT.
When to switch
People usually make this type of switch if new symptoms continue to develop after 6 months of treatment with a DMT. However, keep in mind some medications may take 6 months to become fully active.
Your doctor will also consider the number of relapses you’ve had in the past year.
The more recent your relapse, the more likely it is that your RRMS will respond to a new DMT.
DMTs come in the form of injections as well as oral tablets. Some are also delivered intravenously, or through a vein.
In addition to DMTs, your doctor may prescribe medications to treat symptoms that are directly related to RRMS.
For example, your doctor might recommend antidepressants for anxiety or depression. They might also recommend medications that reduce muscle spasms, such as baclofen (Lioresal, Gablofen).
It’s important that you don’t stop taking these types of medications just because you suspect your current DMT isn’t working. Your doctor will evaluate all of your current medications and help you adjust accordingly.
Suddenly stopping any medication can cause increased symptoms, such as worsening depression when abruptly stopping the use of an antidepressant.
The following side effects are associated with RRMS medications:
- eye swelling (macular edema)
- flu-like symptoms
- gastrointestinal discomfort
- herpes infections
- high blood pressure
- increased liver enzymes, which indicate liver inflammation
- flushing of the skin
- skin reactions, in the case of injectable medications
- thinning hair
- worsening thyroid symptoms, in the case of preexisting related diseases
Regular blood testing can help ensure that any new DMT isn’t adversely affecting the body.
However, if you experience any new or worsening symptoms, it’s likely related to your new medication. At this point, you may talk to your doctor about switching your DMT to get rid of these side effects. If you take multiple medications to manage your symptoms, this process may take time.
Occasional MRI tests are also needed to help your doctor detect changes from MS-related inflammation. These tests are performed once or twice a year, depending on the severity of your condition.
Through an MRI, your doctor will look for any new cerebral lesions, which often have no symptoms. You may also need to change medications if you have new lesions and worsening disability without any notable relapses.
If you’re unhappy with your medication and decide to switch, your doctor will be the ultimate source of guidance. They’ll carefully monitor your condition as you transition between medications in case there are any signs that a certain medication isn’t working.
The good news is that RRMS has a better response to medications than other forms of MS. Still, it can take some trial and error before you find the right therapy for you.
Keep in mind that everyone responds to MS therapies differently, so continue touching base with your doctor to see if your current plan is the best fit.