Fatigue & Treatment

If it's on your mind and it has to do with multiple sclerosis in any way, post it here.

Which Fatigue Medication Works For You?

provigil (modafinil)
10
67%
acetyl l-carnitine (ALCAR)
1
7%
pemoline (cylert)
1
7%
amantadine
3
20%
 
Total votes : 15

tomorrow, tomorrow...

Postby VirtuallyFine » Mon Mar 15, 2004 5:30 pm

lottydotty = Can you take ALA and ALCAR if your on provigil?

I have no idea, but I will be seeing my neuro tomorrow and will ask questions...

wish me luck!

8O
< March 20, 2004 = I want my life back *sigh*
> March 20, 2004 = ...day one on alertec = getting my life back? *grin*
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Postby Shayk » Mon Mar 15, 2004 6:25 pm

Lotty Dotty what a great name!

I have no idea either, so we'll see what Virtually Fine finds out from her neuro.. :)

I have not started the fatigue prescription drugs yet, so am equally anxious to find out.

Sharon
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Postby Guest » Tue Mar 16, 2004 8:08 am

:D Virtualy Fine & Shayk: Thanks for your replies! The Provigil seems to work well but then it wears off. Amantidine didn't work for me at all.
Wouldn't it be nice to find a pill that would make you feel normal?




Lots of luck at your neuro! Let me know how it goes![/b]
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Postby lottydotty » Tue Mar 16, 2004 8:21 am

OOPS! I guess I forgot to log in so it listed me as a guest! Sorry!
MS is the gift that keeps on giving.
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my choice

Postby VirtuallyFine » Tue Mar 16, 2004 5:59 pm

so...I opted for the provigil...although in Canada it goes by another name...

I am going to try it and let my neuro know how it goes...one change at a time so we can be sure of what is working (or not working)...so no ALCAR for now...I will revisit it later if need be...but I am going to send him a follow-up mail b/c I FORGOT to ask if you could take both together...it was a bit of a stressful visit (will explain in another note)...suffice it to say that I ranted and vented b/c I had to justify my fatigue to two other attendings before my neuro got there...my neuro, on the other hand...WAS AMAZING AS PER USUAL! (thank God I got to see him...it made my day)...
< March 20, 2004 = I want my life back *sigh*
> March 20, 2004 = ...day one on alertec = getting my life back? *grin*
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Postby lottydotty » Wed Mar 17, 2004 7:54 am

I'm sorry your visit was so stressful! It took me three months of ranting and raving before I finally got some releif.
Don't worry about asking if they can be taken together. I was just curious for in the future if the Provigil ( Modifinal ) stops working what am I going to do?
Thanks for caring enough to try to find out. I see my neuro soon so I'll ask him then.
MS is the gift that keeps on giving.
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for those who like the details...

Postby VirtuallyFine » Thu Mar 18, 2004 6:01 pm

:idea: where i live it is difficult to get good medical journals..I was happy to find this online: :idea:

http://www.modafinil.com/fatigue.html
(this site has lots of good stuff on modafinil)

Abstract from J Neurol Neurosurg Psychiatry 2002 Feb;72(2):179-83

Objective: To assess the efficacy and safety of modafinil for the treatment of fatigue in multiple sclerosis (MS).

Methods: Patients aged 18-65 years with a diagnosis of MS, a stable disability level 4 on the fatigue severity scale (FSS) were eligible for the 9 week, single blind, phase 2, two centre study. Exclusion criteria included a diagnosis of narcolepsy, sleep apnoea, or clinically significant major systemic disease and recent use of medications affecting fatigue. All patients, who remained blinded for the treatment regimen, received placebo during weeks 1-2, 200 mg/day modafinil during weeks 3-4, 400 mg/day modafinil during weeks 5-6, and placebo during weeks 7-9.

Safety was evaluated by unblinded investigators.

Efficacy was evaluated by self rating scales, using the FSS, the modified fatigue impact scale (MFIS), a visual analogue scale for fatigue (VAS-F), and the Epworth sleepiness scale (ESS).

Adverse events were recorded.

Results: Seventy two patients (MS type: 74% relapsing-remitting; 7% primary progressive; 19% secondary progressive) received treatment. After treatment with 200 mg/day modafinil for 2 weeks, a significant improvement in fatigue versus placebo run in was demonstrated. Mean scores after treatment with 200 mg/day modafinil were: FSS, 4.7 versus 5.5 for placebo (p<0.001); MFIS, 37.7 versus 44.7 (p<0.001); and VAS-F, 5.4 versus 4.5 (p=0.003). Fatigue scores for 400 mg/day modafinil were not significantly improved versus placebo run in. Mean ESS scores were significantly improved (p<0.001) with 200 mg/day modafinil (7.2) and 400 mg/day (7.0) versus the score at baseline (9.5). Serious adverse events were not found at either dose. The most common adverse events were headache, nausea, and aesthenia. Sixty five patients (90%) completed the study.

Conclusions: These data suggest that 200 mg/day modafinil significantly improves fatigue and is well tolerated in patients with MS.
< March 20, 2004 = I want my life back *sigh*
> March 20, 2004 = ...day one on alertec = getting my life back? *grin*
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Postby fightingms » Fri Mar 19, 2004 6:27 am

Good luck with your Provigil....That is what I take. We did have to play with the dose when I first went on it. I needed to feel normal [ not zombie like] during the day....but I also needed to be able to sleep at night!!!

Talk to you later....Kim
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OK! Day 1 of this experiment...

Postby VirtuallyFine » Sat Mar 20, 2004 7:28 am

So...I took my first "Alertec"...the Canadian version of Provigil (aka generically known as Modafinil)...

I opted not to try this during the work week b/c I was not sure what would happen...so, today, Saturday March the 20th 2004, I am embarking on my personal "Am I getting my life back?" study...

I need to temper my reactions / observations today with the psychological excitement I feel in anticipation of this working...with "is it really working?"...I will keep everyone posted!

thanks to all for your input..so nice to be able to have peers to bounce this off of while I was making my decision..

love & hugs to all...

:wink:
< March 20, 2004 = I want my life back *sigh*
> March 20, 2004 = ...day one on alertec = getting my life back? *grin*
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lovely...hope it was not placebo effect...

Postby VirtuallyFine » Sun Mar 21, 2004 5:45 pm

SO! Saturday (day one of Alertec) was a success. I rebuilt a friends PC, went out for drinks and dancing with a group of friends from work, and I had fun...all without wanting to nap! So...combination of things at work here I am sure:

1. I desperately WANT this medication to help...am I convincing myself it is only to discover that I will crash and burn when I am past the "novelty" factor?

2. The medication actually works...oh, please let that be the truth...

I am sure it is a combination of both of the above, I am trying to stay very positive and keep on keepin' on...and if the meds help me in this mental endeavor, well all I can say is WHO HOO!

I really like the fact that I did not "have" to take one today (Sunday)...that this medication is not something I must take everyday...

Let's see how this work week goes...
< March 20, 2004 = I want my life back *sigh*
> March 20, 2004 = ...day one on alertec = getting my life back? *grin*
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Postby fightingms » Mon Mar 22, 2004 3:33 am

Good Luck....I am sure the med will work fine for you......it has worked great for me for over a year now. 8) :roll: .........Kim
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Day Three ~ I think it is more than novelty effect!

Postby VirtuallyFine » Wed Mar 24, 2004 4:18 pm

PROVIGIL, DAY THREE REPORT

I have gone three days now without wondering how I was going to drive home from work...wondering what I could heat up in three minutes or less for dinner so I could go to bed by 8 pm...

WHO HOO!!

I am awake and functioning all afternoon!

:D **HUGE GRIN** :D

AND...(drum roll please)...I have slept through the night for that past three nights as well!!!

:!: **JUMPS UP AND DOWN WITH GLEE** :!:
< March 20, 2004 = I want my life back *sigh*
> March 20, 2004 = ...day one on alertec = getting my life back? *grin*
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Postby LarryLDN » Thu Mar 25, 2004 6:32 am

I just take LDN. That seems to have changed my fatigue issues. Been sleeping more peacefully too.
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multi purpose modafinil!

Postby VirtuallyFine » Thu Apr 01, 2004 7:58 pm

modafinil is working great for me...a read this today and wanted to share...

multi purpose modafinil!

_________________________________________________________

www.ncbi.nlm.nih.gov/entrez (PubMed National Library of Medicine)

Anesth Analg. 2004 Apr;98(4):976-81, table of contents.

Modafinil improves recovery after general anesthesia.

Larijani GE, Goldberg ME, Hojat M, Khaleghi B, Dunn JB, Marr AT.

Department of Anesthesiology, University of Medicine and Dentistry of New Jersey, Cooper Health System, Camden, New Jersey 08103, USA. larijani-ghassem@cooperhealth.edu

Recovery from general anesthesia often involves residual sedation, drowsiness, fatigue, and lack of energy that may last hours to days. Modafinil is a wakefulness-promoting drug approved for patients with excessive daytime sleepiness associated with narcolepsy. We evaluated the effect of single doses of modafinil (200 mg) and placebo in patients recovering from general anesthesia. Thirty-four subjects participated in this prospective, randomized, double-blind study approved by our IRB. Preoperatively, patients were asked to rate various symptoms they had experienced over the previous 24-h using a verbal analog scale (VAS) of 0 to 10 as well as discrete scale when indicated. Postoperatively, once the patient was able to tolerate oral intake and met our institutional discharge criteria, the study drug (modafinil 200 mg or placebo) was administered with a sip of water. Patients were contacted 24 (1) hours after dosing to evaluate postdischarge symptoms. Patients in the placebo group reported significantly more postoperative fatigue (4.8 [3.3] versus 1.4 [1.8]), exhaustion (4.3 [3.3] versus 2.4 [3.1]), or degree of feeling worn out (4.7 [3.6] versus 2.9 [2.4]). Significantly more patients reported moderate to severe fatigue in the placebo group (65% versus 12%). Two major themes of "alertness" and "energy" were expressed by 71% of the patients receiving modafinil versus 18% of those receiving placebo. Patients recovering from general anesthesia can significantly benefit from modafinil. IMPLICATIONS: Modafinil significantly reduces fatigue and improves feelings of alertness and energy in postoperative patients. Patients recovering from general anesthesia can significantly benefit from modafinil administration.
< March 20, 2004 = I want my life back *sigh*
> March 20, 2004 = ...day one on alertec = getting my life back? *grin*
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Re: I had no idea...

Postby A Friend » Sat Apr 03, 2004 12:14 pm

Hi All - I'm a guest around here.

I have not been diagnosed with MS, but the most wonderful and meaningful person in my life has. I do as much research on the subject as possible - one less thing for her to worry about.

The results of the ALCAR study really excited me. Thatr is, until I tried to get it. I found out that ALCAR is not yet legal in Canada. Does anyone know anything about this? I can't find it anywhere and all the nutrition/supplement stores tell me that it hasn't been approved by the Canadian FDA, but that they are looking into it.

Any info/help would be MUCH appreciated,

Thanks!
:D

VirtuallyFine wrote:I had no idea ALCAR was over the counter - I just assumed it was a prescription drug...thank you for enlightening me...I will look into this over the weekend..

thanks so much!
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