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Related Experiment Video

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The Treadmill Fatigue Test: A Simple, High-throughput Assay of Fatigue-like Behavior for the Mouse

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Amantadine for fatigue in multiple sclerosis.

E Pucci¹, P Branãs, R D'Amico

¹ASUR Marche - Zona Territoriale 9, U.O. Neurologia - Ospedale di Macerata, Via Santa Lucia, 3, Macerata, Italy, 62100. eugenio_pucci@yahoo.it

The Cochrane Database of Systematic Reviews

|January 27, 2007

Summary

Amantadine shows minimal and inconsistent benefits for Multiple Sclerosis (MS) fatigue, with poor documentation of its effectiveness and safety. Further high-quality research is needed to confirm any potential benefits and understand side effects.

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Area of Science:

Neurology
Clinical Pharmacology

Background:

Fatigue is a primary disabling symptom in Multiple Sclerosis (MS), significantly impacting patient quality of life.
Current treatment recommendations for MS fatigue lack robust scientific evidence.
Amantadine is often cited as a first-line treatment despite limited supporting data.

Purpose of the Study:

To evaluate the effectiveness and safety of amantadine for treating fatigue in individuals with MS.
To synthesize evidence from randomized controlled trials (RCTs) on amantadine's efficacy in MS-related fatigue.

Main Methods:

Comprehensive literature search across multiple databases (Cochrane MS Group, CENTRAL, MEDLINE, EMBASE) up to July 2006.
Inclusion criteria: randomized, placebo-controlled, double-blind trials of amantadine in MS patients with fatigue.
Data extraction by three reviewers; meta-analysis not performed due to data heterogeneity and inadequacy.

Main Results:

Five trials involving 272 MS patients were included; study quality was generally poor and prone to bias.
Studies reported small, inconsistent improvements in fatigue with amantadine.
Clinical relevance, impact on functioning, and quality of life remain undetermined; side effect rates varied widely (10-57%).

Conclusions:

The efficacy and tolerability of amantadine for MS fatigue are poorly substantiated.
Recommendations include further research into MS fatigue mechanisms, standardized outcome measures, and high-quality RCTs.