text: Greetings!!!  Fascinating question!!  As someone who has been successfully managing the symptoms of MS for over 45 years - R/R for the first 40 of those years, and now Secondary Progressive MS - my answer would depend on what "causes" your MS fatigue the most??? \n\nAs you know, MS fatigue is far and away DIFFERENT from "normal human" fatigue.  AND, each person's MS symptoms are different.  With this as background, I'd offer the following.\n\n1)  Determine your "optimum" activity stage within each 24 hours.  For example, for me I start to go to sleep about 2 - 3 am, and sleep until noon or 1 pm.  My most productive time is 11 pm to 2 am.\n\n2)  Determine your main "cause" of fatigue.  For me, it is interacting with others; any physical activity; and the clenching of my muscles.  For this, I swear by Baclofen, which is a muscle relaxant!!!  AND, I "manage" each day to maxamize my ability to get done what I need to do.\n\n3)  As for taking beta interferon, it's DOCUMENTED success in "decreasing the rate of increased MS exacerbations" is great!!  AND, the greatest successes come with folks like you, who are caught early.  Unfortunately, when I went on Avonex in 1997, it was really too late for me, and, even though I took the shots for 5 years, my symptoms had "solidified" so that I was no longer within R/R, and there are currently no meds for SPMS.\n\nHere are my qualifications for providing you with these answers, and information about the current "best" meds for each MS symptom.\n\n1) I've successfully managed the symptoms of MS for over 45 years.\n2) I was an HR Executive for over 30+ years, and combined my professional and personal expertise in creating a website dedicated to assisting folks with "chronic disease symptoms" better document, communicate, corroborate, and manage their symptoms and the resulting impairments to become expert patients; chronic disease self-managers; and, partner with their doctors to practice patient-centered health care.\n\nhttp://www.disabilitykey.com\n\nMy website contains tons of information in 2 blogs, downloadable free articles and self-help ebooklets, and the Disabilitykey Workbook which contains over 100 pages of how to processes and actual forms - blank and completed examples - to assist folks. This workbook is available for a very small price (under $10).\n\nHere's a blog that I did that discusses not only the top 22 MS symptoms, but what - at least a year ago - were the top medications used to help you better manage those symptoms. The reason that I like this list of symptoms and their associated "management aids" is that precisely because MS has so many symptoms, you may need to take some time to do some "introspection" to figure out which TYPE of symptom do you haave!! For example: do you have "plain vanilla" fatigue, or do you have depression coupled with either pain or fatigue? The management aids for the 3 different "types" of depression are different; so, the more precise and specific you can become shen documenting both your symptoms and how they impair you so that you can better inform your doctor, the better your doctor can assist you with symptom management!!\n\nSo, your Doctor tells you that you have a disease. You know that you have symptoms that impair you in your every day life, but you want your Doctor to give you something to make the pain/symptom go away!\n\nWhat is the best medication for your symptoms, for your illness? Remember, only your Doctor can help you. However, the better informed that you are about what is out there, the better you can discuss alternatives with your Doctor(s).\n\nThe following information comes from the National MS Society website. Now, most disease medication lists start with the brand name first, with the SYMPTOM that it is to address almost as an after thought. BUT, we, the patients, start wit