I have not had any attacks or flares since my diagnosis, which was 4 yrs ago. I have a lot of symptoms such as neuropathy pain and the usual MS symptoms like feeling tired, headaches etc. I take Endep 100 mg a day and that helps me a lot for neuropathy pain and general functioning of everyday life. My question is, as i am struggling more and more with symptoms would it be best to be on a DMD? To prevent worsening and disabling symptoms? My walking is fine, although I get tired and tingling gets a bit worse.
Thank you in advance.
Your question highlights the distinction between symptomatic and disease modifying therapies. Endep is not a disease modifying therapy (will do nothing to alter the course of multiple sclerosis) but rather a symptomatic therapy that can help take the edge off of fluctuating symptoms of multiple sclerosis. Disease modifying therapies help by 1) decreasing the frequency of new MS relapses or attacks, 2) decrease the number of new scars on the MRI scan compared with those who take no disease modifying therapy, and 3) mitigate disability progression over time. As a general rule, I advocate for the use of disease modifying therapies to help prevent issues in the future and I use symptomatic therapies temporarily/intermittently to treat severe symptoms when they occur.
Please see my blog about the rationale for disease modifying therapies here: http://www.healthcarejourney.com/physician-blog/a-commonly-asked-question-about-disease-modifying-therapies-for-multiple-sclerosis.
A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente