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 ) .
HAGIL (Hamburg Vigil Study): a randomized placebo-controlled double-blind study with modafinil for treatment of fatigue in patients with multiple sclerosis
Objective : To reassess the effect of modafinil , a wakefulness-promoting artificial psychostimulant , on fatigue and neuropsychological measures in patients with multiple sclerosis . Methods : Multiple sclerosis ( MS ) patients with a baseline score of ≥4 on the Fatigue Severity Scale ( FSS ) and an Exp and ed Disability Status Scale score < 7 were eligible for the 8-week r and omized , double-blind , placebo-controlled study . Modafinil was dosed up to 200 mg/day within 1 week . Assessment s were performed at baseline and after 4 and 8 weeks . The primary outcome parameter was the mean change of the FSS mean score . Secondary outcome variables were other question naires covering fatigue , daytime sleepiness and sleep quality . Cognitive impairment was assessed by the oral version of the Symbol Digit Modalities Test ( SDMT ) and the Paced Auditory Serial Addition Test ( PASAT ) . Results : The study included 121 MS patients . Dropout rate was 9 % . Both treatment groups showed improvements through time . While mean FSS at 8 weeks showed a trend difference between groups in the intention-to-treat analysis , the primary endpoint was not met . Assessment of cognitive impairment by SDMT and PASAT showed contradictory results . All other secondary endpoints were not met . There was no major safety concern . Conclusions : In general , the study does not support modafinil as an effective treatment for MS fatigue . However , the study shows the need for new study design s and endpoints in MS fatigue studies
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 ) .