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 ) .
Memantine induces reversible neurologic impairment in patients with MS
Background : Cognitive dysfunction is very common in multiple sclerosis ( MS ) and it severely impairs patients ’ quality of life . Thus , we explored whether memantine might improve cognitive performance in patients with MS . Methods : We conducted a pilot trial with memantine ( 30 mg/day ) in patients with MS with cognitive impairment . The trial was design ed as a 1-year , r and omized , double-blind , crossover study comparing memantine against a placebo in 60 patients with MS and cognitive impairment . Cognitive impairment was defined as the performance 1.5 st and ard deviations below the normative data in at least two tests of two cognitive domains in the Brief Repeatable Battery – Neuropsychology . The primary endpoint was improvement of verbal memory and the secondary endpoints were safety and improvements in the other cognitive domains , disability and quality of life . The trial was registered at www . clinical trials.org : NCT00638833 . Results : Although 19 patients had been included , the trial was halted after nine patients reported a worsening of their neurologic symptoms that deteriorated their quality of life . Seven of the nine patients in the memantine arm had blurred vision , fatigue , severe headache , increased muscle weakness , walking difficulties , or unstable gait . Only two patients in the placebo group reported neurologic symptoms and in both cases they were related with changes in their disease-modifying therapy . The adverse events only occurred on reaching the maximum dose ( 30 mg/day ) . After stopping medication , the patients reverted to their baseline disability within a few days . Conclusions : Memantine at a dose of 30 mg/day may induce transient worsening of neurologic symptoms of multiple sclerosis
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 ) .