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 for cognitive impairment in multiple sclerosis: a randomized placebo-controlled trial
Background : Memantine , an NMDA antagonist , is effective for moderate to severe Alzheimer ’s disease . Objective : Determine whether memantine improves cognitive performance ( CP ) among subjects with multiple sclerosis ( MS ) and cognitive impairment ( CI ) . Methods : This double-blind , r and omized , placebo-controlled trial ( Clinical trials.gov NCT00300716 ) compared memantine 10 mg twice a day ( 4 week titration followed by 12 weeks on the highest tolerated dose ) with placebo . The primary outcome was the change from baseline to exit on the  Paced Auditory Serial Addition Test ( PASAT ) and the California Verbal Learning Test-II ( CVLT-II ) Long Delay Free Recall ( LDFR ) . Secondary outcomes included additional neuropsychological tests ; self-report measures of quality of life , fatigue , and depression ; and family/caregiver reports of subjects ’ CI and neuropsychiatric symptoms . Results : The differences between the groups on the change on the PASAT  ( placebo — memantine = 0.0 correct responses , 95 % CI 3.4 , 3.4 ; p = 0.9 ) and on CVLT-II LDFR  ( placebo — memantine = —0.6 words , 95 % CI —2.1 , 0.8 ; p = 0.4 ) as well as on the other cognitive tests were not significant . Subjects on memantine had no serious adverse events ( AEs ) but had more fatigue and neurological AEs as well as , per family members ’ reports , less cognitive improvement and greater neuropsychiatric symptoms than subjects on placebo . Conclusion : Memantine 10 mg twice a day does not improve CP  in subjects with MS , ages 18—65 , without major depression , who have subjective cognitive complaints and perform worse than one SD below the mean on the PASAT or on the California Verbal Learning Test-II  ( total recall or delayed free recall )
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 ) .