Safety and efficacy of amantadine, modafinil, and methylphenidate for fatigue in multiple sclerosis..., 2020, Nourbakhsh et al

J

Jaybee00

Senior Member (Voting Rights)
 
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I was given amantadine for my ME when it was first diagnosed in 1985. It did not help but then again my baby was 3 months old at the time :banghead: The only thing I have ever been prescribed for ME rather than to help a symptom.

It is an antiviral (antiherpes I think)and also used as at the time as a way to reduce cocaine addiction. Am embarrassing drug to get from the chemist :)
 
Anybody who understands anything about fatigue would know this is pointless. That's what happens when people reject reality and substitute their own, they "specialize" in an illusion.

Why are people who understand absolutely nothing about fatigue so often the ones doing the "fatigue" research? Seriously this is ridiculous, basic understanding of the issue being researched is not some nice-to-have.
 
I agree that it was unlikely to find a positive result @rvallee, but sometimes research has to be done to disprove something. At least it looks to have been done well enough to find that these drugs weren't helpful.

I think this finding, especially the finding of more harm, is useful for us. It's another bit of evidence to support the idea that modafinil and methylphenidate aren't helpful for 'fatigue'. When my son went to the Melbourne Royal Childrens' Hospital chronic fatigue clinic, he was prescribed methylphenidate, with the followup appointment scheduled for four months later. The drug didn't help.

From memory, BPS researchers in New South Wales were looking into modafinil for CFS just this year. This particular MS study, (which I haven't looked at but the words placebo-controlled, double blinded and the fact that adverse events were recorded bode well) can support arguments that any study of stimulants in ME/CFS needs to pay close attention to harms. @Simone
 
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https://pubmed.ncbi.nlm.nih.gov/9018019/

Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome
A V Plioplys 1, S Plioplys

Neurobiology 1997;35(1):16-23. doi: 10.1159/000119325.
Abstract


Carnitine is essential for mitochondrial energy production.

Disturbance in mitochondrial function may contribute to or cause the fatigue seen in Chronic Fatigue Syndrome (CFS) patients.

Previous investigations have reported decreased carnitine levels in CFS.

Orally administered L-carnitine is an effective medicine in treating the fatigue seen in a number of chronic neurologic diseases.

Amantadine is one of the most effective medicines for treating the fatigue seen in multiple sclerosis patients.

Isolated reports suggest that it may also be effective in treating CFS patients.

Formal investigations of the use of L-carnitine and amantadine for treating CFS have not been previously reported.

We treated 30 CFS patients in a crossover design comparing L-carnitine and amantadine.

Each medicine was given for 2 months, with a 2-week washout period between medicines.

L-Carnitine or amantadine was alternately assigned as fist medicine.

Amantadine was poorly tolerated by the CFS patients.

Only 15 were able to complete 8 weeks of treatment, the others had to stop taking the medicine due to side effects.

In those individuals who completed 8 weeks of treatment, there was no statistically significant difference in any of the clinical parameters that were followed.

However, with L-carnitine we found statistically significant clinical improvement in 12 of the 18 studied parameters after 8 weeks of treatment.

None of the clinical parameters showed any deterioration.

The greatest improvement took place between 4 and 8 weeks of L-carnitine treatment.

Only 1 patient was unable to complete 8 weeks of treatment due to diarrhea.

L-Carnitine is a safe and very well tolerated medicine which improves the clinical status of CFS patients.

In this study we also analyzed clinical and laboratory correlates of CFS symptomatology and improvement parameters.
Click to expand...

Note that 3000 mg per day of l-carnitine was used; I suspect a lot of people with ME/CFS who hear about l-carnitine don't try it at that sort of dosage. Also some people try acetyl l-carnitine, whose effects are more on the brain from what I understand.

Copied to a new thread here
 
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I have tried Amantadine and found it to be ineffective.

Also of note:
Amantadine for treatment of fatigue in Guillain‐Barré syndrome: a randomised, double blind, placebo controlled, crossover trial
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2117395/
(no effect)

Although not many people realise, or want to admit it, the chronic fatigue (and other symptoms) post-GBS is very similar to ME/CFS.
 
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I tried methylphenidate. No overall benefit. Though possibly of some use as an occasional single-dose for a specific event/activity, in the same way that painkillers can be. But not enough for it to be recommended for ME.
 
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