Whilst there was only a limited pool of relatively small trials and a number of different compounds , we found that collectively , both AChEIs ( donepezil and rivastigmine ) and stimulants ( methylpheni date , modafinil , l‐amphetamine sulfate and lisdexamfetamine dimesylate ) offered no significant benefits over placebo on measures of processing speed , working memory , verbal fluency , verbal memory , visuospatial memory or executive functioning
HighlightsCognitive deficits are present in up to 70 % of people with multiple sclerosis (MS).There are no approved treatments for these difficulties .
We examined whether adjunctive pharmacotherapies can improve cognition in MS.Acetylcholinesterase inhibitors offered no significant benefits over placebo .
Stimulant‐based medications offered no significant benefits over placebo .
& NA ; We sought to examine the effectiveness of acetylcholinesterase inhibitors ( AChEIs ) and stimulant‐based medications for improving cognitive performance in patients with multiple sclerosis ( MS ) .
The effects of l-amphetamine sulfate on cognition in MS patients: results of a randomized controlled trial
Defects in processing speed and memory are common in multiple sclerosis ( MS ) patients . In other population s , amphetamines have been shown to enhance cognition , but their use is limited by adverse behavioral effects . The l-isomer may have equivalent cognition enhancement with less adverse effects due to decreased potency in subcortical areas . The aim of this study was to assess the safety and efficacy of l-amphetamine sulfate in the treatment of cognitive dysfunction in MS . This was a 2:1 r and omized , placebo-controlled , double-blind trial , involving 33 MS clinics across the USA . One hundred and fifty-one clinical ly definite MS patients with documented cognitive dysfunction who were relapse free for ≥90 days , with an Exp and ed Disability Status Scale ( EDSS ) ≤6.5 , and with no other medical/psychiatric condition that may cause psychological dysfunction were r and omized to 30 mg of oral l-amphetamine sulfate or placebo for 29 days , including a dose escalation period . A history of cardiac disease , uncontrolled hypertension or electrocardiograph abnormalities result ed in exclusion . The primary outcomes were the Subject Global Assessment of Change and Symbol Digit Modalities Test ( SDMT ) . Secondary outcomes were the results from the California Verbal Learning Test , second edition ( CVLT2 ) , Brief Visual Memory Test-Revised ( BVMTR ) , and Paced Auditory Serial Addition Test ( PASAT ) . One hundred and thirty-six subjects completed the study . No differences were found at baseline in demographics or in the results of the neuropsychological tests . After treatment , the active group performed significantly better for total learning ( P = 0.041 ) and delayed recall ( P < 0.01 ) on the BVMTR , and for delayed recall ( P = 0.012 ) on the CVLT2 . Five patients ( four from the treatment group , one placebo ) withdrew due to intolerable adverse events . l-amphetamine sulfate was associated with improved learning and memory and was well tolerated in this study . However , because the positive findings were observed on secondary outcome measures , the study requires replication before l-amphetamine sulfate can be recommended for the treatment of cognitive impairment in MS
Whilst there was only a limited pool of relatively small trials and a number of different compounds , we found that collectively , both AChEIs ( donepezil and rivastigmine ) and stimulants ( methylpheni date , modafinil , l‐amphetamine sulfate and lisdexamfetamine dimesylate ) offered no significant benefits over placebo on measures of processing speed , working memory , verbal fluency , verbal memory , visuospatial memory or executive functioning
HighlightsCognitive deficits are present in up to 70 % of people with multiple sclerosis (MS).There are no approved treatments for these difficulties .
We examined whether adjunctive pharmacotherapies can improve cognition in MS.Acetylcholinesterase inhibitors offered no significant benefits over placebo .
Stimulant‐based medications offered no significant benefits over placebo .
& NA ; We sought to examine the effectiveness of acetylcholinesterase inhibitors ( AChEIs ) and stimulant‐based medications for improving cognitive performance in patients with multiple sclerosis ( MS ) .