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[Therapeutic indications for managing symptoms: fatigue]
1Centre d'Investigation Clinique, Fédération de Neurologie, Hôpital Pitié-Salpêtrière, Paris. emmanuelle.waubant@psl.ap-hop-paris.fr
Revue Neurologique
|January 15, 2002
Summary
Multiple sclerosis fatigue, encompassing both asthenia and fatigability, has limited treatment options. Amantadine is the only FDA-approved drug, while other medications are used pragmatically.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Context:
- Fatigue is a prevalent and debilitating symptom in multiple sclerosis (MS).
- The underlying mechanisms of MS fatigue are complex and not fully elucidated.
- Fatigue in MS is often categorized as either asthenia (at rest) or fatigability (during exertion).
Purpose:
- To review the current understanding of fatigue mechanisms in multiple sclerosis.
- To discuss the therapeutic benefits of available pharmacological interventions for MS fatigue.
- To highlight the evidence supporting amantadine and the pragmatic use of other agents.
Summary:
- Amantadine is the sole medication with proven efficacy in randomized controlled trials for multiple sclerosis fatigue.
- Serotonin reuptake inhibitors are pragmatically employed due to the frequent comorbidity of fatigue and depression in MS.
- Aminopyridines show potential in improving fatigability, particularly in the lower limbs.
Impact:
- Provides a concise overview of MS fatigue and its management.
- Informs clinicians about evidence-based and pragmatic treatment strategies.
- Highlights the need for further research into the diverse mechanisms of MS fatigue.