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 ) .
L-amphetamine improves memory in MS patients with objective memory impairment
Background : Memory impairment is prevalent in multiple sclerosis ( MS ) , but no drugs are approved to treat these memory problems . Objective : The objective of the study was to examine the effect of l-amphetamine versus placebo on auditory/verbal memory and visual/spatial memory in MS patients with and without baseline memory impairment . Methods : We conducted a re- analysis of a previously published clinical trial in which MS patients were r and omly assigned to treatment ( 30 mg l-amphetamine , N = 99 ) or placebo ( N = 37 ) in a four-week , double-blind , parallel-group , dose titration trial . Auditory/verbal memory ( CVLT-II : Long Delay Free Recall ) and visual/spatial memory ( BVMT-R : Delayed Recall ) were assessed at baseline and follow-up across subgroups of patients with intact baseline memory ( mean = 50th percentile ) or impaired baseline memory ( mean = 2nd percentile ) . Primary analyses : 2 ( l-amphetamine , placebo ) × 2 ( baseline , follow-up ) , × 2 ( baseline memory intact , baseline memory impaired ) ANOVAs performed separately for auditory/verbal and visual/spatial memory . Results : For both auditory/verbal and visual/spatial memory , we observed significant 2 × 2 × 2 interactions whereby l-amphetamine  improved memory more than placebo , and this effect was specific to patients with baseline memory impairment . Conclusions : Among memory-impaired patients  , memory improved about 48.5 % for those on l-amphetamine , but only 1.0 % on placebo . Treatment with l-amphetamine produced large memory gains among memory-impaired MS patients
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 ) .