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Link to original content: http://pubmed.ncbi.nlm.nih.gov/38988104/
The use of modafinil for the treatment of fatigue in multiple sclerosis: A systematic review and meta-analysis of controlled clinical trials - PubMed Skip to main page content
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Review
. 2024 Jul;14(7):e3623.
doi: 10.1002/brb3.3623.

The use of modafinil for the treatment of fatigue in multiple sclerosis: A systematic review and meta-analysis of controlled clinical trials

Shamas Ghazanfar  1 , Minaam Farooq  2 , Shurjeel Uddin Qazi  1 , Bipin Chaurasia  3 , Ulrike Kaunzner  4
Affiliations
Review

The use of modafinil for the treatment of fatigue in multiple sclerosis: A systematic review and meta-analysis of controlled clinical trials

Shamas Ghazanfar et al. Brain Behav. 2024 Jul.

Abstract

Introduction: Multiple sclerosis (MS) is a debilitating neurological condition affecting nearly one million people across the United States. Among the most prominent symptoms of the condition are excessive fatigue and daytime sleepiness. Numerous clinical trials have investigated the efficacy of modafinil in addressing fatigue among these patients.

Objective: The objective of the present study is to assess the safety and efficacy of modafinil for the treatment of fatigue in MS.

Methodology: An electronic search of PUBMED, ScienceDirect, and Cochrane Central was conducted for articles published from inception to December 2023 using search terms such as "modafinil," "fatigue," and "MS."

Results: Seven studies were included in our analysis. Modafinil leads to a meaningful reduction in fatigue when compared with placebo, as measured by Modified Fatigue Impact Scale [mean difference (MD) = -4.42 [-8.01, -.84]; I2 = 45%; p = .02] and Epworth Sleepiness Scale [MD = -.87 [-1.64, -.10]; I2 = 0%; p = .03]. Modafinil also demonstrated a greater risk of precipitating adverse events (e.g., insomnia, gastrointestinal symptoms) when compared with placebo [RR = 1.30 [1.03, 1.66]; I2 = 0%; p = .03]. In quality-of-life assessments, modafinil was associated with overall improvement in well-being [standardized mean difference = .18 [.01, .35]; I2 = 56%; p = .04].

Conclusion: The data indicates that modafinil confers a therapeutic benefit when treating fatigue in patients with MS and improves overall quality of life; however, there is a risk of precipitating adverse events. Ultimately, higher quality of evidence may be required to better inform clinical management.

Keywords: MFIS; adverse events; fatigue; modafinil; multiple sclerosis; quality of life.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflicts of interest.

Figures

FIGURE A
FIGURE A
Preferred Reporting Items for Systematic Review and Meta‐Analyses (PRISMA) chart.
FIGURE 1
FIGURE 1
Modified form of the Fatigue Impact Scale (MFIS) (modafinil vs. placebo and modafinil vs. l‐carnitine).
FIGURE 2
FIGURE 2
Adverse events (modafinil vs. placebo).
FIGURE 3
FIGURE 3
Quality of life (modafinil vs. placebo).
FIGURE 4
FIGURE 4
Epworth Sleepiness Scale (ESS) (modafinil vs. placebo).
FIGURE 5
FIGURE 5
Fatigue Severity Scale (FSS) (modafinil vs. placebo).
FIGURE 6
FIGURE 6
Risk of bias (RoB) summary plot.
FIGURE 7
FIGURE 7
Risk of bias (RoB) summary chart.
FIGURE 8
FIGURE 8
Eggers plot for publication bias.
See this image and copyright information in PMC

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References

    1. Al‐Shammari, A. H. , Abbood, Z. A. , & Lateef, H. F. (2023). Assessing the impacts of l‐carnitine and modafinil on fatigue in Iraqi multiple sclerosis patients. Journal of Advanced Pharmaceutical Technology & Research, 14(3), 226–228. 10.4103/JAPTR.JAPTR_225_23 - DOI - PMC - PubMed
    1. Ayache, S. S. , Serratrice, N. , Abi Lahoud, G. N. , & Chalah, M. A. (2022). Fatigue in multiple sclerosis: A review of the exploratory and therapeutic potential of non‐invasive brain stimulation. Frontiers in Neurology, 13, 813965. 10.3389/fneur.2022.813965 - DOI - PMC - PubMed
    1. Battleday, R. M. , & Brem, A. K. (2016). Modafinil for cognitive neuroenhancement in healthy non‐sleep‐deprived subjects: A systematic review. European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 26(2), 391. 10.1016/j.euroneuro.2015.12.023 - DOI - PubMed
    1. Braley, T. J. , & Chervin, R. D. (2010). Fatigue in multiple sclerosis: Mechanisms, evaluation, and treatment. Sleep, 33(8), 1061–1067. 10.1093/sleep/33.8.1061 - DOI - PMC - PubMed
    1. Ford‐Johnson, L. , DeLuca, J. , Zhang, J. , Elovic, E. , Lengenfelder, J. , & Chiaravalloti, N. D. (2016). Cognitive effects of modafinil in patients with multiple sclerosis: A clinical trial. Rehabilitation Psychology, 61(1), 82–91. 10.1037/a0039919 - DOI - PubMed

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