Friday, 14 October 2011

Modafinil Can Improve Physical Fatigue in Patients With Parkinson’s Disease

Modafinil can reduced physical fatigue commonly seen in patients with Parkinson’s disease, researchers reported here at the 132nd Annual Meeting of the American Neurological Association (ANA).
“It was very gratifying to find that modafinil improves physical fatigue in patients with Parkinson’s disease,” reflected study presenter Jau-Shin Lou, MD, Associate Professor of Neurology, University of Oregon Medical School, Portland, Oregon, United States.
Dr. Lou concluded that, “at the regular dose used in narcolepsy, modafinil clearly reduced physical fatigue in Parkinson’s disease.”
Dr. Lou and colleagues undertook the study because Parkinson’s disease patients at all stages of the disease are known to have physical fatigue. Studies have shown that more than half of patients with Parkinson’s experience physical fatigue. “This is a well-documented phenomenon,” he lamented.
“Modafinil is approved for narcolepsy and has been shown to improve fatigue in multiple sclerosis, so we deduced that it was worth evaluating in Parkinson’s disease,” said Dr. Lou.
In their study, the researchers assessed fatigue levels in 19 Parkinson’s disease patients using the Multidimensional Fatigue Inventory (MFI), a measurement tool that has been in use for about 20 years.
Nine patients who were on current Parkinson’s disease treatments were randomly assigned to modafinil 100 mg BID and 10 patients received placebo. Finger tapping and intermittent force generation were used to evaluate physical fatigue objectively and MFI was used to measure fatigue subjectively. Subjects completed the Epworth Sleepiness Scale (ESS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the multidimensional McGill Quality of Life (MQOL).
Results showed that the modafinil group, but not the placebo group, showed increased finger tapping frequency (P <.05), increased tapping velocity (P <.05), less fatigue from finger tapping (P <.05), less general fatigue in the MFI (P <.05), less fatigue from intermittent force generation (P <.1), and less sleepiness (P <.1) from week 1 to 8. Both groups reported improved quality of life.
Dr. Lou concluded that, “at the regular dose used in narcolepsy, modafinil clearly reduced physical fatigue in Parkinson’s disease.”
He recommended that physicians prescribe modafinil to their patients with Parkinson’s disease who are suffering from fatigue.
“The agent can be used as an adjunctive medication to levodopa or a dopamine agonist,” he added.
Dr. Lou and his group hope to perform a larger trial, “but there’s no need to wait to start using modafinil,” he urged.

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