Tuesday, April 12, 2005

Modafinil for Fatigue in Multiple Sclerosis

B. Stankoff, MD, PhD, E. Waubant, MD, PhD, C. Confavreux, MD, G. Edan, MD, M. Debouverie, MD, L. Rumbach, MD, T. Moreau, MD, PhD, J. Pelletier, MD, PhD, C. Lubetzki, MD, PhD, M. Clanet, MD, PhD and French Modafinil Study Group.
Modafinil for fatigue in MS: A randomized placebo-controlled double-blind study. Neurology 2005; 64: 1139-1143.

From the Fédération de Neurologie (Drs. Stankoff and Lubetzki), Centre d’Investigation Clinique (Drs. Stankoff and Waubant), Hôpital de la Salpêtrière, AP-HP, Paris, France; Services de Neurologie, CHU de Lyon (Dr. Confavreux), Rennes (Dr. Edan), Nancy (Dr. Debouverie), Besançon (Dr. Rumbach), Dijon (Dr. Moreau), and Marseille (Dr. Pelletier); Fédération de Neurologie (Dr. Clanet), CHU de Toulouse, France; and UCSF MS Center (Dr. Waubant), San Francisco, CA.

Objective: To assess whether modafinil, a wakefulness-promoting agent, is useful for fatigue in patients with multiple sclerosis (MS).

Methods: Patients with MS with stable disability, and a baseline score of 45 or more on the Modified Fatigue Impact Scale (MFIS), were eligible for the 5-week randomized, double-blind, placebo-controlled, parallel group study. The initial daily dose of modafinil was 200 mg for 1 week. Depending on tolerance, the dose was increased by 100 mg every week up to 400 mg/day and remained unchanged between day 21 and day 35. The primary outcome variable was the change of MFIS score at day 35.

Results: A total of 115 patients with MS were enrolled in the study and in the intention to treat analysis. The mean MFIS score at baseline was 63 ± 9 in the placebo group and 63 ± 10 in the modafinil group. MFIS scores improved between day 0 and day 35 in both placebo-treated and modafinil-treated groups, but no significant difference was detected between the two groups. There was no major safety concern.

Conclusions: There was no improvement of fatigue in patients with multiple sclerosis treated with modafinil vs placebo according to the Modified Fatigue Impact Scale.


Czes Kulvis said...

As a Multiple Sclerosis sufferer I am experiencing much fatigue, so I am searching for means (preferably natural) to reduce my constant tiredness.

Regretfully, that's not so easy.

Anyhow, thanks for nice post

Louise said...

Modafinil (marketed as provigil in the United States) has made all the difference to me. I really encourage you to try it. I have been using it for over three years.