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 periods of worsening symptoms or brand-new symptoms (relapse).

During remission, sometimes the symptoms that remain become permanent.

Over time, inflammation affects 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 need to be modified.

If you’re having new symptoms, you may be thinking about switching your medications. While switching RRMS medications might help, you’ll need to work with your doctor to ensure the transition is as smooth as possible.

Before you stop your current treatment plan and start another one, be sure to discuss safety considerations, including dosing information, effectiveness, and the possibility of side effects with your doctor.

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.

A 2015 review of research 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 taking medication and experiencing the above symptoms in a new or worsening fashion, then it’s time to consider a new DMT.

When to switch

People usually switch medications if new symptoms continue to develop or a relapse occurs.

When considering DMT therapy, it’s important to consider many factors, including:

  • the benefits of the DMT
  • your preferences
  • your doctor’s monitoring recommendations
  • the medication’s side effects
  • any other health conditions you may have

During a 6-month follow-up, your doctor may suggest switching medications. However, you might need to switch earlier than 6 months if you experience side effects or a relapse.

Depending on the type of therapy, changing medications might require a washout period, in which the previous medication is eliminated from the body before starting a new one.

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 your RRMS will respond to a new DMT.

DMTs come as injections or oral tablets. Some are also delivered intravenously, or through a vein.

In the past, when starting DMTs, doctors would first prescribe treatments with a lower effectiveness due to fewer side effects. If these treatments didn’t work, doctors would prescribe what are known as high efficacy therapies (HETs).

However, more recent studies have shown that starting with HETs first can lower the chance of relapse and minimize neurological damage earlier on. You may want to talk with your doctor about which type of therapy is right for you.

In addition to DMTs, your doctor may prescribe medications to treat symptoms 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 do not 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 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
  • skin flushing
  • skin reactions, in the case of injectable medications
  • thinning hair
  • worsening thyroid symptoms, in the case of preexisting related conditions

Regular blood testing can help ensure 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 can talk with your doctor about switching your DMT. 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.

With an MRI, your doctor looks 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 is the ultimate source of guidance. They will carefully monitor your condition as you transition between medications in case there are any signs that a certain medication isn’t working.

RRMS can have 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.