There she was all perky and happy. She was shopping. She was hanging out with friends. She was radiating sunshine and it made me a grumpy cloud of irritation. Holy smokes! It was yet another new multiple sclerosis (MS) drug. Another one. It felt like there was a new one every month. I say felt because it is not true. It just seemed that way. I was beginning to experience drug modifying therapy (DMT) fatigue. 

DMT fatigue happens when an MS patient is tapped out and exhausted by the many new available drugs. From the ubiquitous television ads to slick 2-pagers in many MS print magazines, if you are living with MS the options can be dizzying. Each year seems to bring new breakthroughs in treating this chronic illness. People with MS can be easily overloaded with the offerings and deciding on which treatment to try.

Anyone who was diagnosed with MS before 1993 and the introduction of Betaseron, interferon-alpha was the primary trial treatment. Since then, nearly 20 new DMTs have been approved by the Food and Drug Administration (FDA) for the treatment of MS. The oral, injection, and infusion choices continue to stack up for those diagnosed with relapsing MS, formerly known as relapsing-remitting.


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When I was first diagnosed, I was not given an option other than a daily injection as my only choice. Oral therapy was later offered to me, much to my surprise. I was delighted at having more than a single DMT from which I could choose the best fit for my lifestyle and preference.

At the time, I was only aware of the 2 options presented. I had not yet done any research into DMTs, so the choice was easier to make. As time has gone on, the variety of prescribed medications have sprouted like weeds in a deserted parking lot. While this is much better than the time when there were no approved treatments, it can cause a form of mental paralysis for MS patients.

Ever since prescription drug advertising was approved, Americans are bombarded with commercials for drugs. We are poked and prodded into asking our healthcare professionals for specific drugs. This is not inherently bad. It is wonderful to have so many options to help us deal with MS. We can find a DMT that best fits with our current state of health and other medications. If we are comfortable with a daily or weekly medication we have drugs taken by mouth or those that are quick and relatively painless to inject. Infusions that are done twice a year might fit better for others.

With this new terrain, it is more essential than ever for healthcare professionals to lead the way in assisting patients to choose the DMT that is best for them. That may include choosing nothing at all. What is most important is asking the right questions and listening before recommending a course of treatment.

MS patients look to their HCPs as a source of information and advice when it comes to choosing medications. We may have a general idea of what we want to do. We may have decided that oral medication is the way to go. We will then look to you for help in choosing among the drugs available. We want to know which ones do not conflict with our current regimen. We want to know the downsides and complications. We want a beacon of light in a dark, confusing tunnel with voices echoing from every side. 

That is why it is incumbent upon our healthcare teammate to provide that information. We need for you to be up-to-date on DMTs in order to make a choice that best addresses our main MS issues and works with our current lifestyle. Even patients that have proactively educated themselves can use input because they cannot think of everything themselves. MS HCPs can be fierce gladiators for their patients trying to navigate the DMT arenas. It is a matter of taking up the cause and understanding that their help is needed and necessary.