For multiple sclerosis, medication and cognitive behavioral therapy can reduce fatigue
In a study of commonly used treatments for people with multiple sclerosis, both medical and behavioral interventions, and a combination of the two, resulted in meaningful improvements in fatigue, a University of Michigan-led study finds.
The randomized clinical trial compared the effectiveness of modafinil, a wake-promoting medication used to treat sleepiness in people with sleep disorders, and cognitive behavioral therapy, or CBT, on reducing fatigue for over 300 adults with multiple sclerosis whose symptoms interfered with their daily activities.
Overall, investigators found that treatment with either modafinil or CBT alone, which was delivered over the phone, was associated with significant reductions of fatigue over 12 weeks.
A combination of both treatments also worked as well as each individual treatment but did not result in better fatigue scores than the independent interventions.
The findings are published in The Lancet Neurology.
The research used a real world approach that more closely resembled clinical practice than traditional clinical trials and included stakeholders with MS who helped design the study.
More than 60% of participants in each group of the study reported clinically meaningful improvement in fatigue, which was measured with a survey called the Modified Fatigue Impact Scale.
Trial participants who received only CBT maintained lower fatigue scores at an additional follow-up appointment 12 weeks after the study treatments ended.
Although the three treatment assignments worked similarly well overall, participants’ sleep habits, or “sleep hygiene”, affected how well the treatment worked for fatigue.
Those with poor sleep hygiene tended to have better fatigue outcomes with CBT, and participants with very good sleep hygiene showed better fatigue outcomes with modafinil.
