Provigil doesn’t help MS fatigue but aspirin might

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Provigil, a drug used to treat the sudden-sleep disorder Narcolepsy, does not affect fatigue experienced by people with multiple sclerosis (MS), results of a trial suggest.

However, a separate study found that aspirin may be of some benefit. Both studies appeared in the medical journal Neurology.

Two small pilot studies recently showed a positive impact of Provigil, technically known as modafinil, on MS-related fatigue, note Dr. Bruno Stankoff, at Hopital de la Salpetriere in Paris and members of the French Modafinil Study Group, in the first study.

To further investigate, the group randomly assigned 56 patients scoring 45 points or more on a fatigue scale to modafinil, and 59 to an inactive placebo.

Both groups experienced decreased fatigue during the 35-day trial, but change in fatigue scores did not differ significantly between the two groups.

In the second study, Dr. Dean M. Wingerchuk and colleagues point out that some MS patients using aspirin for other purposes report reduced fatigue.

In crossover trial, 30 patients with MS-related fatigue took either aspirin twice daily or placebo for 6 weeks in random order, separated by a 2-week “washout” period.

Average scores on one fatigue scale were lower during aspirin treatment (38.1 versus 42.5), but responses did not differ significantly on two other scales.

Commenting in a related editorial, Drs. Steven R. Schwid of the University of Rochester, New York, and T. Jock Murray of Dalhousie University in Halifax, Nova Scotia, observe that “until we make progress in distinguishing fatigue from other MS symptoms, in identifying its mechanisms and in measuring it accurately, we will not make substantial progress in treating this disabling symptom.”

SOURCE: Neurology, April 12, 2005.

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