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 ) .
Multicenter randomized clinical trial of donepezil for memory impairment in multiple sclerosis
Objectives : The goal of this study was to determine if memory would be improved by donepezil as compared to placebo in a multicenter , double-blind , r and omized clinical trial ( RCT ) . Methods : Donepezil 10 mg daily was compared to placebo to treat memory impairment . Eligibility criteria included the following : age 18–59 years , clinical ly definite multiple sclerosis ( MS ) , and performance ≤½ SD below published norms on the Rey Auditory Verbal Learning Test ( RAVLT ) .  Neuropsychological assessment s were performed at baseline and 24 weeks . Primary outcomes were change on the Selective Reminding Test ( SRT ) of verbal memory and the participant 's impression of memory change . Secondary outcomes included changes on other neuropsychological tests and the evaluating clinician 's impression of memory change . Results : A total of 120 participants were enrolled and r and omized to either donepezil or placebo . No significant treatment effects were found between groups on either primary outcome of memory or any secondary cognitive outcomes . A trend was noted for the clinician 's impression of memory change in favor of donepezil ( 37.7 % ) vs placebo ( 23.7 % ) ( p = 0.097 ) . No serious or unanticipated adverse events attributed to study medication developed . Conclusions : Donepezil did not improve memory as compared to placebo on either of the primary outcomes in this study . Classification of evidence : This study provides Class I evidence which does not support the hypothesis that 10 mg of donepezil daily for 24 weeks is superior to placebo in improving cognition as measured by the SRT in people with MS whose baseline RAVLT score was 0.5 SD or more below average
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 ) .