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 ) .
Fatigue in progressive multiple sclerosis: results of a randomized, double-blind, placebo-controlled, crossover trial of oral 4-aminopyridine
Previous studies suggest that aminopyridine may play a role in the symptomatic treatment of fatigue in multiple sclerosis . Although the mechanism underlying the beneficial effect on fatigue remains unclear , it has been proposed that aminopyridines may help to improve conduction in demyelinated central pathways , implicating both axonal and synaptic mechanisms . The objective of the present study is to determine whether 4-AP decreases daily-living fatigue in progressive multiple sclerosis . The effect of 4-AP on other neurophysiological and neuropsychological parameters was also considered . A ` double-blind ' , r and omized , ` placebo-controlled ' , crossover trial was conducted on 54 patients with progressive multiple sclerosis . All patients received treatment with placebo and 32 mg per day of 4-AP , each for 6 months . The main outcome measure was the Fatigue Severity Scale . Secondary measures were EDSS , cognitive functions and neurophysiological parameters .  Forty-nine patients ( 91 % ) completed the study .  Changes in fatigue scores , EDSS and cognitive functions were not significantly different between 4-AP and placebo . However , when patients treated with 4-AP were divided into two groups according to the serum level of 4-AP , a significant effect on fatigue compared with placebo was observed in the ` high level ' ( 430 ng/ml ) group ( P=0.05 ) . Synchronization of motor evoked potentials improved during 4-AP with respect to placebo ( P=0.019 ) and this correlated positively with fatigue reduction ( P=0.010 ) . No relevant side effects were observed
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 ) .