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C. Perello (Quilmes, RA)
The chronic fatigue is actually recognized as the most common symptom in patients with MS, many studies about this item, show us that, between the 75% and 95% of the persosn with MS, suffer fatigue, and approximately among 50% to 60% of that individuals, related that fatigue is one of their major difficulties.

Objetives: The study persecute the objetive to demostrate the tolerability (adverse effects) and the level of efficiency, and the appropiate dose proportion, and the best dose of Sulbutiamine in the treatment of fatigue and sleep disorders in patients with MS.

Materials and Methods: The evaluation was made over 60 patients with MS, that related chronic fatigue. (40 women, 20 men, with an age average of 40,8±10.5 years). All of the individuals received Sulbutiamine. Two persons were excluded because they experimented gastrointestinal intolerance. The chronic fatigue was defined as a subjetive loss of the vital energy that is perceived by the individuals or caregiver to interfere with usual and desired activities through a amount of time higher than 6 weeks.
The exclusion criteria include, narcolepsy, sleep apnea, the use of steroids in the last three months, acute exacerbation of MS in the last 8 weeks. The change of the prescription, or the dose of antidepressives drugs in the last 3 weeks, the use of central nervous system depressors, diabetes mellitus, hepatic and renal insufficiency. MS was diagnosticate using the Mac Donald et als. inclusion criteria. The disease severity was established through the Expanded Disability Status Scale (EDSS) or Kurtzke scale. In order to obtain a consistent information that contribute to use efficiently a strategic terapeutic, we considered three cuestionnaires, similar of currently use by the Fatigue Guidelines Development Panel of the Multiple Sclerosis Society of USA.

Results: Individuales that were under treatment with Sulbutiamine during 6 months (43 patients 74,13%) revealed a substantial improvement in their clinc status, 10 patients (17,24%) experimented some improvement and 5 indiviuals (8,62%) told us, that they didn't improve their fatigue. Not one patient demostrated clinic deterioration. 38 patients (65,51%) had considered, that treatment was satisfactory, 13 persons had determined that it was regular, and 7 individuals (12,06%) mentioned that the result was modest.

21st Congress of the European Committee for the Treatment and Research in Multiple Sclerosis
10th Annual Meeting of the Americas Committee for Treatment and Research in Multiple Sclerosis

Pharmacologic and therapeutic features of sulbutiamine.
Abstract
Asthenia is the most frequent medical reason for people seeking help from their physician. In 75% of cases, the cause is functional (either reactive or psychiatric) and in 25% it is organic. In order to provide patients with rapid relief of symptoms, appropriate antiasthenic treatment should be initiated immediately, while at the same time, adequate clinical and laboratory assessments should be performed to detect the underlying cause of asthenia. Sulbutiamine, a highly lipophilic thiamine derivative, is the only antiasthenic compound known to cross the blood-brain barrier and to be selectively active on specific brain structures directly involved in asthenia. This article reviews the current knowledge on the effects of sulbutiamine in animal models and in various forms of human asthenia.

Adjuvant role of vitamin B analogue (sulbutiamine) with anti-infective treatment in infection associated asthenia.
AIMS OF THE STUDY:
Asthenic symptoms such as weakness accompany illness. This study investigates whether the centrally acting cholinergic agent, vitamin B analogue (sulbutiamine), is effective and acceptable in relieving these symptoms in infectious disease when combined with specific anti-infective treatment.
METHODOLOGY:
In a prospective uncontrolled, non-randomised, commercial, observational study, 1772 patients with an infectious disease and asthenic symptoms, drawn from the practice of 350 randomly selected physicians throughout India, received vitamin B analogue (sulbutiamine) in addition to specific anti-infective treatment for 15 days. The primary outcome variable was complete resolution of asthenic symptoms with treatment.
RESULTS:
The number (%, 95% confidence interval) of patients with complete resolution of all asthenic symptoms was 916 (51.7, 49.4-54). In the remaining patients, severe asthenia was reduced but persisted in 11 (0.6, 0-26); and moderate asthenia in 94 (5.3, 0-17.6). The response was greater in patients with acute infection and symptoms more related to cerebral function. Side effects occurred in 10 (0.6%), patients and well being improved significantly.
CONCLUSIONS:
Vitamin B analogue (sulbutiamine) may be a useful adjunct to specific anti-infective treatment.