Modafinil for multiple sclerosis fatigue: does it work?
Modafinil is sometimes used in the clinical setting for treating multiple sclerosis (MS) fatigue, despite conflicting and disappointing results from clinical trials. OBJECTIVE: We audited the patient perceived effectiveness of modafinil when used in clinical practice in a carefully selected group of patients with typical MS fatigue. METHODS: All MS patients commenced on modafinil for fatigue in the Oxford MS clinic were identified retrospectively, and the patient perceived benefit, side effects and decision on continuation of therapy at 1 month was obtained from the medical notes. Additionally all patients were subsequently interviewed, up to 5 years after treatment initiation. RESULTS: Surprisingly, 69% patients with fatigue also suffered excessive daytime sleepiness, and this subgroup found modafinil more beneficial. There was a better response against excessive daytime sleepiness than fatigue. The benefit against fatigue or sleepiness was generally sustained (median 1 year). CONCLUS
