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02:09

How to Choose the Right Multiple Sclerosis Treatment With Your Doctor

There are short-term treatments to relieve MS flares and long-term treatments to prevent progression.

Hilary WeissmanMera Goodman, MD, FAAP
Written by Hilary Weissman | Reviewed by Mera Goodman, MD, FAAP
Updated on April 30, 2024

“There are a lot of different factors to consider when choosing a multiple sclerosis (MS) medication,” says Asaff Harel, MD, neurologist and Director of the Multiple Sclerosis Center at Lenox Hill Hospital, Northwell Health. “With over 20 different options… it really requires an open dialogue between you and your physician.”

There are two key categories of medications. First, there are short-term treatments to relieve multiple sclerosis flares. Then, there are long-term treatments to slow or prevent progression of the condition. 

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Each treatment has a different schedule, like every day, every month, or every six months. They could come as a pill, injectable, or infusion medication. Choosing which is best for you at any given moment of your journey will depend on a few factors.

How do you choose the right MS medication with your doctor?

When it comes to simply responding to and de-escalating flare ups, your treatment might include intravenous corticosteroids or plasma exchange.

For a more comprehensive, preventative strategy, your doctor will turn to disease-modifying treatments (DMARDs). There are a few different types:

  1. Injections that you give yourself

  2. Infusions that you receive from an IV at an infusion center

  3. Oral treatments (pills) that you take regularly

There are pros and cons to each type. You may be able to choose which option is more convenient for you. Some people may only be eligible for one type and may not have as much of a choice.

Other factors you and your doctor will need to consider include:

  1. The severity of your condition

  2. The subtype of your MS

  3. Other conditions you may have

  4. Other medicines you’re taking, and whether they’ll interact 

  5. Your age

“You really have to factor in your lifestyle, your values essentially, and your risk tolerance. There are some medications that have a higher risk, but that may have a greater benefit with regards to controlling MS,” says Dr. Harel. “That discussion of risks and benefits of certain medications is a really important discussion to have with your physician.”

What are questions to ask your doctor about your treatment options?

It’s important to remember that you play an important role in your care team. The more you understand your treatment plan, the better you’ll be able to carry it out. This may help improve your treatment outcomes.

Types of questions you can ask your doctor when choosing a treatment include:

  1. How will it affect my lifestyle, job, and schedule?

  2. What if I’m trying to conceive?

  3. What if I have a busy schedule?

  4. What if I travel a lot?

  5. What are the side effects?

  6. Are there long-term risks?

  7. How much will this cost?

  8. Will my insurance cover any of these options?

  9. How often will I have to administer this treatment?

  10. How often will I have to return to your office?

  11. What do your other patients think of this medication?

  12. How will this interact with my other medications?

  13. What do I need to know about my co-morbidities?

  14. How does this medication need to be stored?

  15. Why do you think this treatment is right for me?

What should you do if the first treatment you try is not a good fit?

Even after you’ve made a choice, be honest with your doctor if you don’t think your treatment is a good fit. Because there are so many medication options today, you and your doctor can generally try other options to find the right fit.

There are also plenty of complementary lifestyle changes you can make to support your treatment, like fish oil supplements, movement like yoga and reflexology, and even acupuncture.

Additional Medical Contributors
  • Asaff Harel, MDAsaff Harel, MD, is a Neurologist specializing in multiple sclerosis and related neuro-immunological conditions, serving as the Director of the Multiple Sclerosis Center at Lenox Hill Hospital, Northwell Health.

    References

    Gajofatto, A. et al. (2015) Treatment strategies for multiple sclerosis: When to start, when to change, when to stop? World Journal of Clinical Cases.

    MedlinePlus.gov. (2021). Multiple sclerosis.

    View All References (6)

    Multiple Sclerosis Association of America. (n.d.). Welcome to the MSAA ultimate MS treatment guide.

    National Center for Complementary and Integrative Health. (2019). Ayurvedic medicine: in depth.

    National Center for Complementary and Integrative Health. (2019). Multiple sclerosis.

    National Institute of Neurological Disorders and Stroke. (2023). Multiple sclerosis: What research is being done?

    National Multiple Sclerosis Society. (n.d.). Treating MS.

    University of Michigan Health. (2023). Multiple sclerosis: Should I start taking medicines for MS?

    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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