Source: Ohio State University
Provigil Therapy Found To Relieve Fatigue Of Multiple Sclerosis Patients
January 21, 2002
COLUMBUS, Ohio - For the first time, researchers here have found an effective
therapy that can alleviate the fatigue often accompanying multiple sclerosis.
Many therapies have been developed to treat symptoms of multiple sclerosis,
but few have helped, to any degree, the excessive, debilitating fatigue
that accompanies other disease symptoms in some patients.
Their study appears today in the Journal of Neurology, Neurosurgery and
Psychiatry.
Dr. Kottil W. Rammohan, neurologist at The Ohio State University Medical
Center, and his colleagues wondered whether the drug modafinil might be
effective in relieving this fatigue. Modafinil is used currently in the
treatment of narcolepsy, a disease in which patients experience uncontrolled
daytime sleepiness.
"We were very pleased to find that a medication that was effective
against narcolepsy was able to treat the fatigue associated with multiple
sclerosis."
Two doses of modafinil (200 and 400 mg) were compared against a placebo
in 72 patients with multiple sclerosis ranging in age from 18 to 65. It
was observed that the 200 mg dose of the drug administered once daily
showed highly significant improvement in patients. Three separate instruments
of rating fatigue were used, and all three showed concordant response
to this drug. No previous drug has been able to show this degree of improvement
in treating multiple sclerosis-related fatigue in any previous clinical
trial.
"We were very pleased to find that a medication that was effective
against narcolepsy was able to treat the fatigue associated with multiple
sclerosis," said Rammohan, lead author of the study.
Rammohan's group also looked at the potential side effects associated
with this medication and found that they were not greater than those experienced
by patients in the study who received a placebo.
"It is always exciting to find an effective therapy that is void
of serious side effects," said Rammohan.
Fatigue is one of the most common and disabling symptoms of multiple
sclerosis. It affects 75 to 90 percent of patients with the disease. As
many as 46 to 66 percent of multiple sclerosis patients experience fatigue
on a daily basis.
Rammohan said that more studies are needed to better understand the dosage
and length of therapy necessary for patients, but he hopes more neurologists
will start using modafinil for the treatment of severe fatigue that often
accompanies multiple sclerosis.
Also participating in this study were researchers at Kaiser Permanente
in San Diego.
Multiple sclerosis is an unpredictable, progressive disease in which
scattered patches of nerve fibers in the brain and spinal cord lose "myelin,"
their protective covering. Resultant loss of neurological function can
manifest with a multitude of symptoms.
In addition to fatigue, patients experience a combination of a number
of symptoms that include visual loss, loss of motor function, sensory
impairment, imbalance, bowel and bladder dysfunction, and sometimes problems
related to cognition, memory and personality. Multiple sclerosis is a
common disorder and affects about 350,000 people in the United States,
mostly women.
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