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Amantadine, modafinil, and methylphenidate for MS-related fatigue

MS Virtual 2020
For fatigue, one of the most prevalent subjective symptoms in MS patients, methylphenidate, modafinil, and amantadine are commonly prescribed. Substantial evidence supporting their efficacy is however lacking. In the randomised crossover TRIUMPHANT-MS trial, none of these 3 agents was superior to placebo in improving MS-related fatigue, but they did cause more adverse events [1]. The TRIUMPHANT-MS trial compared the efficacy of twice-daily oral methylphenidate, modafinil, and amantadine against each other and placebo. Eligible patients had MS-related fatigue with a Modified Fatigue Impact Scale (MFIS) score of >33. EDSS score at the time of screening ranged from 0.0 to 7.0. A total of 141 adult patients received 1 of 4 treatment sequences: amantadine, placebo, modafinil, methylphenidate; placebo...

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