News from American Psychiatric Association meeting
Provigil Reduces Fatigue in Patients With Fibromyalgia
By Karla Gale, Reuters Health, May 22, 2006
Modafinil (Provigil), a drug first developed for the treatment of narcolepsy,
alleviates some of the fatigue that patients with fibromyalgia experience,
according to a presentation today at the American Psychiatric Association's
2006 annual meeting in Toronto.
"We were impressed with the drug's ability to relieve fatigue in
other areas, such as depression, anxiety, multiple sclerosis, and Parkinson's
disease, so it made sense that it would be a very good drug for alleviating
symptoms of fatigue in fibromyalgia patients," presenter Dr. Thomas
L. Schwartz told Reuters Health.
In addition to narcolepsy, modafinil is approved by the US Food and Drug
Administration for use in obstructive sleep apnea/hypopnea syndrome and
shift work sleep disorder.
Dr. Schwartz and his associate, Dr. Susan M. Chlebowski at SUNY Upstate
in Syracuse, New York, performed a chart review of 98 consecutive patients
with fibromyalgia whose treatment regimen included modafinil. Dosage ranged
from 200 to 400 mg/day.
"These patients had an average baseline visual-analog score of 7
(out of 10), which indicates very marked fatigue," Dr. Schwartz said.
"Modafinil reduced their fatigue levels to between 3 or 4, suggesting
that it did relatively well."
Only about one-third of patients did not benefit at all from treatment
with modafinil, the researcher added.
"The typical side effects are headache, dizziness, and nervousness,"
Dr. Schwartz noted. Also, "it is a low level controlled substance
with a mild addiction potential, so physicians will want to be careful
when using modafinil in patients with substance abuse issues."
He pointed out that modafinil "can disrupt birth control pills."
Therefore, women should be advised to use an additional contraceptive
agent during modafinil treatment.
In their meeting abstract, Dr. Schwartz and Dr. Chlebowski conclude:
"In clinical practice, fibromyalgia is often treated with a complex
regimen of physical therapy, psychotherapy, biofeedback and polypharmacy.
Modafinil seems to be a reasonable addition to this multimodal treatment
approach."
Provigil for fibromyalgia
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