Switching RRMS Medications? Talk with These 6 People First

Curated by Claudia Shannon / Research Scientist / ishonest

Switching medications for relapse-remitting multiple sclerosis (RRMS) is a common occurrence. This is especially true of disease-modifying therapies (DMTs), which are taken to help control RRMS progression.

Currently, 14 types of DMTs are available. You might even be taking a separate pain medication during relapses (known as “attacks”). If you’re on an antidepressant, there is a chance you might change medications in the future as well.

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One type of healthcare professional could very well prescribe you a different form or dosage of these types of medications. However, it’s important to make sure that all of the members of your healthcare team are in the loop. Be sure to discuss any changes with the following six members or groups of people right away.

1. Your doctors

This can include your primary care doctor as well as a specialized doctor such as a neurologist. If your primary doctor prescribes additional medications, you should notify your neurologist. For example, some people with RRMS start to experience high blood pressure or low red blood cell counts, and may need some additional medications. Your specialty doctors will need to know about these medication changes in case any of them interact with different drugs they might plan on prescribing you.

Similarly, if your neurologist prescribes a new DMT, for instance, you should notify your primary care doctor. As a rule of thumb, your primary doctor will be your first contact should you make any significant changes. Primary care doctors often coordinate care with specialists — not the other way around.

2. Others with RRMS

Before making medication switches, you might consider reaching out to others living with RRMS. Drug changes are common, so chances are you’ll be able to find someone who’s been in your shoes.

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Local support groups are great ways to meet other people with MS. Many of these groups also focus on specialty topics, such as treatment management and self- care. Some support groups may be online.

Discussing medications with others with RRMS can help give you insights into the pros and cons of the process — just be sure to keep in mind that DMTs affect everyone differently.

If you need some help finding a group, consider checking out the National MS Society’s location tool here.

3. Your rehabilitation therapists

If you see rehabilitation therapists, you should also disclose any medication changes with these individuals. Included are:

  • physical therapists
  • occupational therapists
  • speech/language pathologists
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While rehabilitation therapists don’t prescribe medications or make these types of changes to your treatment plan, they’re well-versed in how MS drugs can affect their patients. If you’re trying a new DMT, for example, then your physical therapist might be on the lookout for any unusual fatigue as a side effect. Also, your rehabilitation therapists can offer new techniques to manage your symptoms or medication side effects.

4. Your nutritionist

Your nutritionist is another member of your healthcare team who doesn’t manage your medications. However, a nutritionist does keep clients’ medication lists in mind so they can recommend meal plans more effectively to help with:

  • weight management
  • constipation
  • fatigue
  • overall wellness

Sometimes medications can affect these concerns. For instance, an antidepressant might cause weight gain. Disclosing your medication lists with your nutritionist can help them better understand such effects. They will also be able to determine when dietary changes will or won’t help.

5. Mental health specialists

If you see a mental health specialist, such as a psychologist or psychiatrist, you will also need to share RRMS medication changes with them, too. You might be seeing a neuropsychologist to help monitor cognitive changes. You may even be seeing a psychiatrist to help manage stress, anxiety, and depression associated with your RRMS.

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These types of mental health specialists might prescribe medications or supplements, so they need to know your most up-to-date MS treatment plan. This can help prevent drug interactions. For example, if you take high doses of ibuprofen (Advil) for pain, a psychiatrist may not be able to prescribe certain antidepressants. This combination of medicines can cause stomach bleeding.

6. Your family or caregiver

Talking to your family and caregivers ahead of time can help make sure they’re prepared and aware of your RRMS medication changes. This way, they can be better prepared to help you along your treatment path.

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