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Clin Neurol Neurosurg. 2013 Dec;115 Suppl 1:S86-9. doi: 10.1016/j.clineuro.2013.09.029.

Evaluating the effects of amantadin, modafinil and acetyl-L-carnitine on fatigue in multiple sclerosis--result of a pilot randomized, blind study.

Author information

1
Department of Neurology, University Medical Center, Ljubljana, Slovenia. Electronic address: alenka.horvat@kclj.si.

Abstract

OBJECTIVE:

Fatigue affects more than 60% of multiple sclerosis (MS) patients and is one of the most troublesome symptoms of the disease. Current treatment options for MS fatigue include amantadine, modafinil and acetyl-l-carnitine (ALCAR). The aim of our study was to compare efficacy of amantadine, modafinil and ALCAR with placebo in patients with MS.

METHODS:

Patients with MS and a disability level ≤ 5.5 on the Kurtzke Expanded Disability Status Scale (EDSS) and fatigue were included in the study. Patients were assigned to a one month treatment with either amantadine 200mg, ALCAR 2g, modafinil 200mg or placebo. Efficacy of the treatment was evaluated by using the modified fatigue impact scale (MFIS).

RESULTS:

Sixty patients were included in the study (39 females). The mean age of patients was 38 ± 6.7 years and the mean disease duration was 6.6 ± 1.2 years. Contrast analysis showed significantly lower mean MFIS score after one month in patients on amantadine compared to placebo (mean difference=17.3, p=0.001). There was also a trend of a lower MFIS score in ALCAR group in comparison to placebo (mean difference=12.4, p=0.05, with Keppel-corrected alpha of 0.046). The quality of life measured as SF 36 - PCS and SF 36 - MCS proved to be significantly influenced by treatment.

CONCLUSION:

One month treatment with amantadine improved fatigue in patients with relapsing-remitting MS as evaluated by MFIS. No or only a trend of improvement was seen in patients treated with modafinil or ALCAR, respectively.

KEYWORDS:

Acetyl-l-carnitine; Amantadine; Fatigue; Modafinil; Multiple sclerosis

PMID:
24321164
DOI:
10.1016/j.clineuro.2013.09.029
[Indexed for MEDLINE]

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