COLUMBUS, Ohio - For the first time, researchers here have found an effective therapy that can alleviate the fatigue often accompanying multiple sclerosis. Many therapies have been developed to treat symptoms of multiple sclerosis, but few have helped, to any degree, the excessive, debilitating fatigue that accompanies other disease symptoms in some patients.
Their study appears today in the Journal of Neurology, Neurosurgery and Psychiatry.
Dr. Kottil W. Rammohan, neurologist at The Ohio State University Medical Center, and his colleagues wondered whether the drug modafinil might be effective in relieving this fatigue. Modafinil is used currently in the treatment of narcolepsy, a disease in which patients experience uncontrolled daytime sleepiness.
"We were very pleased to find that a medication that was effective against narcolepsy was able to treat the fatigue associated with multiple sclerosis."
Two doses of modafinil (200 and 400 mg) were compared against a placebo in 72 patients with multiple sclerosis ranging in age from 18 to 65. It was observed that the 200 mg dose of the drug administered once daily showed highly significant improvement in patients. Three separate instruments of rating fatigue were used, and all three showed concordant response to this drug. No previous drug has been able to show this degree of improvement in treating multiple sclerosis-related fatigue in any previous clinical trial.
"We were very pleased to find that a medication that was effective against narcolepsy was able to treat the fatigue associated with multiple sclerosis," said Rammohan, lead author of the study.
Rammohan's group also looked at the potential side effects associated with this medication and found that they were not greater than those experienced by patients in the study who received a placebo.
"It is always exciting to find an effective therapy that is void of serious side effects," said Rammohan.
Fatigue is one of the most common and disabling symptoms of multiple sclerosis. It affects 75 to 90 percent of patients with the disease. As many as 46 to 66 percent of multiple sclerosis patients experience fatigue on a daily basis.
Rammohan said that more studies are needed to better understand the dosage and length of therapy necessary for patients, but he hopes more neurologists will start using modafinil for the treatment of severe fatigue that often accompanies multiple sclerosis.
Also participating in this study were researchers at Kaiser Permanente in San Diego.
Multiple sclerosis is an unpredictable, progressive disease in which scattered patches of nerve fibers in the brain and spinal cord lose "myelin," their protective covering. Resultant loss of neurological function can manifest with a multitude of symptoms.
In addition to fatigue, patients experience a combination of a number of symptoms that include visual loss, loss of motor function, sensory impairment, imbalance, bowel and bladder dysfunction, and sometimes problems related to cognition, memory and personality. Multiple sclerosis is a common disorder and affects about 350,000 people in the United States, mostly women.
Contact: Betsy Samuels, Medical Center Communications, 614-293-3737, or samuels-1@medctr.osu.edu
(Editor's Note: This story embargoed until Jan. 18, 2002 to coincide with publication of a paper in the Journal of Neurology, Neurosurgery and Psychiatry.)