Brandon Beaber, MD, is a multiple sclerosis (MS) neurologist based in Southern California. He adjusts common mindsets that can get in the way of people starting MS disease-modifying therapies.

In terms of disease-modifying therapies — and for those who don’t know, these are medications are purely for prevention — they don’t make you feel better. It’s kind of like if you take an aspirin to prevent a heart attack: It’s not going to make you run faster. It’s just for prevention.

This can be a little bit confusing, as many people do improve while taking these treatments, but that’s just your own natural improvement over time, which is common in MS, not the treatment itself. Now, one general thing I would say is that obviously everyone’s situation is different. There are comorbid medical conditions. Maybe a young woman who wants to get pregnant, then you have to consider pregnancy safety.

There’s increasing evidence that the stronger treatments are better. It may be a bit counterintuitive. Someone who’s young and healthy and has minimal problems with MS may think to themselves, “I don’t want to take a risky medicine.” There’s actually increasing evidence that it’s better to be aggressive upfront and get the disease under control.

And that’s a little bit counterintuitive, but I think there’s increasing evidence that’s the right way to go for many people — not everyone, but for many people.