No Benefit of 3 Commonly Used Medications in MS Fatigue

A new placebo-controlled trial has shown no benefit over placebo of three different drugs commonly used to treat fatigue in patients with multiple sclerosis (MS).

The TRIUMPHANT study found no difference between the effects of amantadine, modafinil, methylphenidate, and placebo in the Modified Fatigue Impact Scale (MFIS) in a study involving 141 patients with multiple sclerosis.

There was also no difference between any of the drugs and placebo in any of the pre-planned subgroups which included different Expanded Disability Status Scale scores, depressive scores, use of disease-modifying therapy, or type of MS (relapsing-remitting or progressive).

The research was presented on AAN.com as part of the 2020 American Academy of Neurology Science Highlights.
[...]
However, in a post-hoc analysis there was an improvement in fatigue severity with two of the drugs — methylphenidate and modafinil — in patients with excessive daytime sleepiness.
Click to expand...
 
The drugs: amantadine, modafinil, methylphenidate. Not surprised about the last 2 not being effective, never heard of the first.

Just like pain, the entire field of fatigue research needs a complete reset. You can't progress without a basic understanding of what it is, starting with a damn common and clear vocabulary. Literally start over from scratch with a fresh batch of people, there's nothing of value to be found in there yet.

Case in point:
However, in a post-hoc analysis there was an improvement in fatigue severity with two of the drugs — methylphenidate and modafinil — in patients with excessive daytime sleepiness
Click to expand...
Fatigue is not sleepiness. Just. Stop. You are very bad at this. :banghead:

Wait, no, I meant :banghead::banghead::banghead::banghead::banghead::
Fatigue is a common and debilitating symptom of MS, occurring in about 70% to 80% of patients with MS. There is no approved drug treatment. However nonpharmacological therapies have shown some success: studies of exercise and cognitive behavioral therapy (CBT) have shown these may be effective without causing side effects, Nourbakhsh noted. "So we should be getting patients to try exercise and CBT before jumping to medication."
Click to expand...
Actually what I meant is: :banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead:
"It also is important to address any factors besides MS that may be causing or contributing to fatigue, for example, sleep disruption, medication side effects, depression, other medical conditions such as anemia or hypothyroidism," he added.
Click to expand...
Have you literally never checked the scientific literature on this topic? Seriously?
 
Last edited:
InitialConditions said:
It needs to be stated again that medicine really doesn't understand fatigue, nor know how to treat it.
Click to expand...

Yes, I keep thinking of that quoted tweet of Dr Amy Small (I think IIRC)

Having long-covid symptoms she acknowledged that as a dr she had no idea what people meant when talking about post viral fatigue. Fatigue seemed inadequate. I'm restating this but I believe this was the gist.

Doctors inevitably think that people who come in with chronic symptoms of pain and / or fatigue are equivalent to what they have experienced in their lives if they ever had these symptoms in some acute illness or physical trauma.
 
Last edited:
Snowdrop said:
Yes, I keep thinking of that quoted tweet of Dr Amy Small (I think IIRC)

Having long-covid symptoms she acknowledged that as a dr she had no idea what people meant when talking about post viral fatigue. Fatigue seemed inadequate. I'm restating this but I believe this was the gist.

Doctors inevitably think that people who come in with chronic symptoms of pain and / or fatigue are equivalent to what they have experienced in their lives if the even had these symptoms in some acute illness or physical trauma.
Click to expand...
This
 
chrisb said:
Amantadine was tried in ME. I don't know whether there was ever a trial, but it was not beneficial.
Click to expand...

It was used to treat herpesvirus and cocaine addiction so it was embarrassing to collect from the chemist :)

I was given it in 1985 but it did not help my fatigue. It may have influenced my results that I had a 9 month old baby who slept for 2 hours a day.
 
You must log in or register to reply here.
Back
Top Bottom