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 ) .
Lisdexamfetamine dimesylate improves processing speed and memory in cognitively impaired MS patients: a phase II study
Multiple sclerosis ( MS ) causes cognitive impairment including slowed processing speed and problems with learning and memory . Stimulants are attractive c and i date s for improving mental speed but carry risk of addiction and other adverse behavioral effects . Lisdexamfetamine dimesylate ( LDX ) is a d-amphetamine prodrug currently approved for attention deficit ( hyperactivity ) disorder with the potential to be better tolerated due to its prolonged clinical effect . This phase II placebo-controlled , double-blind study aim ed to assess the safety and efficacy of LDX in cognitively impaired MS patients . Subjects were patients with clinical ly definite MS , aged 18–56 years , and impaired on either of two primary outcomes : the Symbol Digit Modalities Test ( SDMT ) or the  Paced Auditory Serial Addition Test ( PASAT ) . Both SDMT and PASAT are measures of cognitive processing speed . Of 174 MS patients screened , 63 were r and omized to 30 mg of LDX or placebo in a 2:1 fashion ; the dose was increased as tolerated to 70 mg over 4 weeks and then maintained for another 4 weeks . Secondary outcomes were the Brief Visuospatial Memory Test Revised ( BVMTR ) , the California Verbal Learning Test 2nd edition ( CVLT2 ) , both measures of episodic memory , and the Behavioral Rating Inventory of Executive Function for adults ( BRIEF-A ) , a self-report measure of executive function . Fatigue and depression were also evaluated . There was significant improvement in the SDMT score ( + 4.6 vs. + 1.3 ) and CVLT2 score ( + 4.7 vs. −0.9 ) in the LDX group compared with the placebo group among the 49 completers . There was no change on the other outcomes . A high proportion of both LDX-treated and placebo-treated subjects reported adverse events ( 73.5 % vs. 68.4 % ) . However , there were no serious adverse events noted in the study . These preliminary data indicate that LDX has the potential to be an efficacious treatment for MS patients with cognitive impairment
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 ) .