Navigating polypharmacy and addressing debilitating symptoms in multiple sclerosis patients

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I see a lot of patients with multiple sclerosis (MS) in my clinic, all with different health histories, different overriding symptoms such as uncontrolled spasms interfering with sleep, gut dysmotility, fatigue, insomnia, and inability to manage stress. Some of my patients are at the relapsing remitting stage (RRMS), while others have been diagnosed with secondary progressive MS (SPMS) by the time they come to me. According to a 2016 review in Journal of Neurology, early and effective…