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 ) .
Ginkgo biloba does not improve cognitive function in MS
Objective : To determine whether Ginkgo biloba extract ( ginkgo ) improves cognitive function in persons with multiple sclerosis ( MS ) . Methods : Persons with MS from the Seattle and Portl and VA clinics and adjacent communities who scored 1 SD or more below the mean on one of 4 neuropsychological tests ( Stroop Test , California Verbal Learning Test II [ CVLT-II ] , Controlled Oral Word Association Test [ COWAT ] , and Paced Auditory Serial Addition Task [ PASAT ] )  were r and omly assigned to receive either one 120-mg tablet of ginkgo ( EGb-761 ; Willmar Schwabe GmbH & Co , Germany ) or one placebo tablet twice a day for 12 weeks . As the primary outcome , we compared the performance of the 2 groups on the 4 tests at exit after adjusting for baseline performance . Results : Fifty-nine subjects received placebo  and 61 received ginkgo ; 1 participant receiving placebo and 3 receiving ginkgo were lost to follow-up . Two serious adverse events ( AEs ) ( myocardial infa rct ion and severe depression ) believed to be unrelated to the treatment occurred in the ginkgo group ; otherwise , there were no significant differences in AEs . The differences ( ginkgo − placebo ) at exit in the z scores for the cognitive tests were as follows : PASAT −0.2 ( 95 % confidence interval [ CI ] −0.5 to 0.1 ) ; Stroop Test −0.5 ( 95 % CI −0.9 to −0.1 ) ; COWAT 0.0 ( 95 % CI −0.2 to 0.3 ) ; and CVLT-II 0.0 ( 95 % CI −0.3 to 0.3 ) ; none was statistically significant . Conclusions : Treatment with ginkgo 120 mg twice a day did not improve cognitive performance in persons with MS . Classification of evidence : This study provides Class I evidence that treatment with ginkgo 120 mg twice a day for 12 weeks does not improve cognitive performance in people with 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 ) .