title: Evaluating the effects of amantadin, modafinil and acetyl-L-carnitine on fatigue in multiple sclerosis--result of a pilot randomized, blind study.
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.
  
  
  CONCLUSIONS
  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.
authors: Department of Neurology, University Medical Center, Ljubljana, Slovenia. Electronic address: alenka.horvat@kclj.si.
authors: Alenka Horvat
authors: AH
authors: Ledinek
authors: Mojca Cizek
authors: MC
authors: Sajko
authors: Uros
authors: U
authors: Rot
mesh_terms: D000108:Acetylcarnitine / Q000627:therapeutic use*; D000328:Adult; D000547:Amantadine / Q000627:therapeutic use*; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D004338:Drug Combinations; D005221:Fatigue / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077408:Modafinil; D009103:Multiple Sclerosis / Q000188:drug therapy*; D010865:Pilot Projects; D016896:Treatment Outcome
chemical_list: D001559:Benzhydryl Compounds; D004338:Drug Combinations; D000108:Acetylcarnitine; D000547:Amantadine; D000077408:Modafinil
keywords: Acetyl-l-carnitine; Amantadine; Fatigue; Modafinil; Multiple sclerosis