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Methylphenidate as Treatment Option of Fatigue in Multiple Sclerosis

Information source: Medical University of Vienna
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Multiple Sclerosis; Fatigue

Intervention: Methylphenidate modified release (Drug); Maltodextrin (Drug)

Phase: Phase 2

Status: Recruiting

Sponsored by: Medical University of Vienna

Official(s) and/or principal investigator(s):
Fritz Leutmezer, MD, Principal Investigator, Affiliation: Medical University of Vienna, Department of Neurology

Overall contact:
Fritz Leutmezer, MD, Phone: +43 1 40400, Ext: 3120, Email: fritz.leutmezer@meduniwien.ac.at

Summary

Fatigue is a common symptom in multiple sclerosis (MS) that is characterized by physical and/or mental exhaustion. Fatigue is difficult to treat and treatment efficacy of available therapy is limited. The goal of this study is to determine whether MS-associated fatigue improves after 6 weeks of methylphenidate therapy. Treatment efficacy will be measured by a questionnaire called "Fatigue Severity Scale" (FSS).

Clinical Details

Official title: Methylphenidate Modified-release as Treatment of MS-associated Fatigue. A Single-center Randomized Double-blind Placebo-controlled Study.

Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Primary outcome: Change of Fatigue as measured by Fatigue Severity Scale

Secondary outcome: Change of Fatigue as measured by Modified Fatigue Impact Scale (MFIS)

Detailed description: The management oft fatigue comprises nonpharmacologic approaches like exercise, cooling procedures, nutrition, and energy conservation programmes. These strategies should be considered as first-line options since they add to overall wellbeing, have no side effects and increase the patient's autonomy. However, in most cases these strategies will not suffice to keep the patient symptom free on the long term. Also, patients with overwhelming and severe fatigue will be unlikely to engage in exercise. In these cases adding pharmacologic therapy will be the next step. Until now, Amantadine, Modafinil, and Pemoline have been used among others, with some success. Also antidepressants like buprione, fluoxetine, and venlafaxine have been used although they have never been systematically studied for the management of MS-related fatigue. However, if a mood disorder is present, it is appropriate to treat it before pursuing pharmacologic therapy of fatigue. Nevertheless, the response rate of all pharmacologic therapies of MS-related fatigue is not totally convincing making alternative pharmacologic therapies furthermore desirable. Methylphenidate is an antagonist of dopamine and norepinephrine transporters on the presynaptic neuronal cell membrane. Reduced reuptake results in an increase in extracellular levels of both neurotransmitters. Until now, methylphenidate has been successfully used to treat fatigue in HIV and parkinson´s disease, data on its efficacy in MS are not available. The aim of this study is to determine the efficacy of methylphenidate treatment in MS-associated fatigue. The treatment phase will be 6 weeks and treatment efficacy will be measured by validated questionnaires (Fatigue Severity Scale FSS, modified Fatigue Impact Scale MFIS) and by a neuropsychological test (Test for Attentional Performance).

Eligibility

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Diagnosis of multiple sclerosis according to McDonalds criteria.

- Age > 18 years

- Fatigue as measured by Fatigue Severity Scale

- Signed informed consent

Exclusion Criteria:

- Known allergy or hypersensitivity to Methylphenidate or any of its ingredients

- Marked anxiety, tension and agitation

- Patients with glaucoma or hyperthyroidism

- Patients with motor‐tics, a family history or diagnosis of Tourette´s syndrome

- Treatment with monoamine oxidase inhibitors, also within a minimum of 14 days

following discontinuation (hypertensive crisis may result).

- Phaeochromocytoma

- Pre‐existing cardiovascular disorders including severe hypertension, angina, arterial

occlusive disorder, heart failure, haemodynamically significant congenital heart disease, cardiomyopathies, myocardial infarction, potentially life‐threatening arrhythmias and channelopathies.

- History of drug dependence or alcoholism

- History of seizures

- Pregnant women or females of childbearing potential who want to become pregnant

within the study period.

- Severe psychiatric disorders

- Change of any medication treatment <8 weeks before starting the study

- Participation in any other clinical trial at the same time

Locations and Contacts

Fritz Leutmezer, MD, Phone: +43 1 40400, Ext: 3120, Email: fritz.leutmezer@meduniwien.ac.at

Medical University of Vienna, Department of Neurology, Vienna 1090, Austria; Recruiting
Fritz Leutmezer, MD, Phone: +43 1 40400, Ext: 3120, Email: fritz.leutmezer@meduniwien.ac.at
Fritz Leutmezer, MD, Principal Investigator
Additional Information

Starting date: December 2012
Last updated: May 8, 2015

Page last updated: August 23, 2015

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