BACKGROUND: Fatigue is one of the most common and disabling symptoms of @entity1 with @entity15 ( @entity15 ). The effective management of @entity1295 has an important impact on the @entity1 's functioning, abilities, and quality of life. Although a number of strategies have been devised for reducing @entity1295 , treatment recommendations are based on a limited amount of scientific evidence. Many textbooks report @entity7776 as a first-choice drug for @entity15 -related @entity1295 because of published randomised controlled trials (RCTs) showing some benefit. We performed a systematic review in order to gather existing evidence, and contribute to the topic. OBJECTIVES: To determine the effectiveness and safety of @entity7776 in reducing @entity1295 in @entity1 with @entity15 . SEARCH STRATEGY: RCTs of @entity7776 were identified using MEDLINE, EMBASE, bibliographies of relevant articles, personal communications, manual searches of relevant journals, and information from drug companies. SELECTION CRITERIA: Randomised, placebo or other drugs-controlled, double-blind trials of @entity7776 in @entity15 @entity1 with @entity1295 . DATA COLLECTION AND ANALYSIS: Three reviewers selected studies for inclusion in the review and they extracted the data reported in the original articles. Missing and unclear data were requested by correspondence with the trial's principal investigator. A meta-analysis was not performed due to the inadequacy of available data, heterogeneity of outcome measures. MAIN RESULTS: Out of twelve pertinent publications, four trials met the criteria for inclusion in this review: one study was a parallel arms study, and 3 were crossover trials. The number of randomised @entity1 ranged between 10 and 115, and a total of 236 @entity15 @entity1 had been studied. Overall the quality of the studies considered was poor and all trials were open to bias. All studies reported small and inconstant improvements in @entity1295 , whereas the clinical relevance of these findings and the impact on @entity1 's functioning and health related quality of life remains undetermined. The number of @entity1 reporting side effects during @entity7776 therapy ranged from 10% to 57%, without significant differences between treatment and placebo. The side effects reported were generally mild, and discontinuation of the drug due to side effects occurred in less than 10% of the @entity1 . REVIEWER'S CONCLUSIONS: @entity7776 treatment is overall well tolerated, however its efficacy in reducing @entity1295 in @entity1 with @entity15 is poorly documented and there is insufficient evidence to make recommendations to guide prescribing. It is advisable to (a) improve knowledge on the underlying mechanisms of @entity15 -related @entity1295 ; (b) achieve an agreement on accurate, reliable and responsive outcome measures of @entity1295 ; (c) perform good quality RCTs.

@entity7776 for @entity1295 in XXXX .

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'patient', 'people'] @entity15 :: ('MESH:D009103', 'Disease') :: ['MS', 'Multiple Sclerosis'] @entity7776 :: ('MESH:D000547', 'Chemical') :: ['amantadine', 'Amantadine'] @entity1295 :: ('MESH:D005221', 'Disease') :: ['fatigue']
@entity15 :: (MESH:D009103,Disease) :: ['multiple sclerosis']
