Pharmacological treatment for memory disorder in multiple sclerosis

Area of Science:

• Neuroscience
• Pharmacology
• Clinical Trials

Background:

• Multiple sclerosis (MS) is a CNS disorder causing cognitive impairment, particularly memory deficits, impacting daily function.
• Existing randomized controlled trials (RCTs) on pharmacological treatments for MS-related memory issues yield inconsistent results.
• This review updates previous findings on drug efficacy for memory disorders in individuals with MS.

Purpose of the Study:

• To evaluate the efficacy, tolerability, and safety of pharmacological interventions for memory impairment in adults with MS.
• To compare the effects of various drugs against placebo or other pharmacological agents.

Main Methods:

• Searched multiple databases (Cochrane, PsycINFO, CBMdisc) and trial registries for relevant RCTs up to July 2013.
• Included double-blind, randomized controlled trials of pharmacological treatments versus placebo or other drugs in adults with MS and mild memory impairment.
• Assessed trial quality and extracted data independently; contacted investigators for additional information.

Main Results:

• Seven RCTs (625 participants) evaluated donepezil, ginkgo biloba, memantine, and rivastigmine; most studies had methodological limitations and heterogeneity.
• Donepezil showed no significant improvement in memory recall or cognitive tests compared to placebo, despite good tolerability.
• Adverse events for donepezil included diarrhea, nausea, and abnormal dreams; Ginkgo biloba, memantine, and rivastigmine were safe and well-tolerated.

Conclusions:

• Limited quality of available RCTs prevents drawing firm conclusions on the efficacy of pharmacological treatments for MS-associated memory disorder.
• Moderate-quality evidence suggests donepezil is not effective for mild memory impairment in MS patients but is well-tolerated.
• Future large-scale, high-quality RCTs are necessary to definitively assess the effectiveness of these treatments.