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Published in: Clinical and Translational Medicine 1/2019

Open Access 01-12-2019 | Multiple Sclerosis | Research

Comparison of the effects of amantadine and ondansetron in treatment of fatigue in patients with multiple sclerosis

Authors: Mojtaba Khazaei, Ashkan Karevan, Mohammad Taheri, Soudeh Ghafouri-Fard

Published in: Clinical and Translational Medicine | Issue 1/2019

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Abstract

Background

Multiple sclerosis (MS) is a common neurological disorder with a variety of manifestations including fatigue. Fatigue may interfere with daily work and activities. Different pharmacological and non-pharmacological methods have been used for treatment of this symptom in MS patients. In this study, the effect of ondansetron and amantadine in the treatment of fatigue was compared.

Methods

In this randomized clinical trial, 53 MS patients with fatigability were enrolled (mean age ± standard deviation: 54.00 ± 7.88, Female/male ratio: 45/8). Patients were referred to Imam Clinic and Sina Hospital, Hamadan, Iran. Patients were assessed using the Fatigue Severity Scale (FSS) questionnaire. Patients were randomly assigned to either the amantadine or ondansetron treatment groups and received treatments in a crossover manner. The severity of fatigue was measured using FSS questionnaire in four stages (beginning and end of each regimen). Data were analyzed using SPSS software version 16.

Results

The mean and standard deviation of patients’ fatigue scores before treatment were 43.07 ± 10.36 and 43.22 ± 9.67 in the amantadine and ondansetron group, respectively. These scores were 37.36 ± 7.87 and 40.00 ± 8.94 after treatment in the amantadine and ondansetron group, respectively. Both drugs significantly decreased the fatigue severity of patients (P < 0.001). There was no statistically significant difference between two regimens in terms of the mean score of fatigue before and after treatment and the frequency of complications. However, when ranking the severity of fatigue (mild, moderate, severe), fatigue reduction after intervention in the amantadine group was significantly higher than ondansetron (P = 0.026).

Conclusion

Both amantadine and ondansetron reduce fatigue in MS patients, but the efficacy of amantadine in reducing the MS-associated fatigue is greater than that of ondansetron.
Literature
1.
go back to reference Braley TJ, Chervin RD (2010) Fatigue in multiple sclerosis: mechanisms, evaluation, and treatment. Sleep 33(8):1061–1067CrossRef Braley TJ, Chervin RD (2010) Fatigue in multiple sclerosis: mechanisms, evaluation, and treatment. Sleep 33(8):1061–1067CrossRef
2.
go back to reference Nagaraj K, Taly AB, Gupta A, Prasad C, Christopher R (2013) Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life. J Neurosci Rural Pract 4(3):278–282 (Epub 2013/11/20) CrossRef Nagaraj K, Taly AB, Gupta A, Prasad C, Christopher R (2013) Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life. J Neurosci Rural Pract 4(3):278–282 (Epub 2013/11/20) CrossRef
3.
go back to reference Krupp LB, Alvarez LA, LaRocca NG, Scheinberg LC (1988) Fatigue in multiple sclerosis. Arch Neurol 45(4):435–437 (Epub 1988/04/01) CrossRef Krupp LB, Alvarez LA, LaRocca NG, Scheinberg LC (1988) Fatigue in multiple sclerosis. Arch Neurol 45(4):435–437 (Epub 1988/04/01) CrossRef
4.
go back to reference Janardhan V, Bakshi R (2002) Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. J Neurol Sci 205(1):51–58 (Epub 2002/11/01) CrossRef Janardhan V, Bakshi R (2002) Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. J Neurol Sci 205(1):51–58 (Epub 2002/11/01) CrossRef
5.
go back to reference Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The Fatigue Severity Scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121–1123 (Epub 1989/10/01) CrossRef Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The Fatigue Severity Scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121–1123 (Epub 1989/10/01) CrossRef
6.
go back to reference Miller P, Soundy A (2017) The pharmacological and non-pharmacological interventions for the management of fatigue related multiple sclerosis. J Neurol Sci 381:41–54 (Epub 2017/10/11) CrossRef Miller P, Soundy A (2017) The pharmacological and non-pharmacological interventions for the management of fatigue related multiple sclerosis. J Neurol Sci 381:41–54 (Epub 2017/10/11) CrossRef
7.
go back to reference Generali JA, Cada DJ (2014) Amantadine: multiple sclerosis-related fatigue. Hosp Pharm 49(8):710–712CrossRef Generali JA, Cada DJ (2014) Amantadine: multiple sclerosis-related fatigue. Hosp Pharm 49(8):710–712CrossRef
8.
go back to reference Shaygannejad V, Janghorbani M, Ashtari F, Zakeri H (2012) Comparison of the effect of aspirin and amantadine for the treatment of fatigue in multiple sclerosis: a randomized, blinded, crossover study. Neurol Res 34(9):854–858 (Epub 2012/09/18) CrossRef Shaygannejad V, Janghorbani M, Ashtari F, Zakeri H (2012) Comparison of the effect of aspirin and amantadine for the treatment of fatigue in multiple sclerosis: a randomized, blinded, crossover study. Neurol Res 34(9):854–858 (Epub 2012/09/18) CrossRef
9.
go back to reference Ledinek AH, Sajko MC, Rot U (2013) Evaluating the effects of amantadine, modafinil and acetyl-L-carnitine on fatigue in multiple sclerosis—result of a pilot randomized, blind study. Clin Neurol Neurosurg 115(Suppl 1):S86–S89 (Epub 2014/01/01) CrossRef Ledinek AH, Sajko MC, Rot U (2013) Evaluating the effects of amantadine, modafinil and acetyl-L-carnitine on fatigue in multiple sclerosis—result of a pilot randomized, blind study. Clin Neurol Neurosurg 115(Suppl 1):S86–S89 (Epub 2014/01/01) CrossRef
10.
go back to reference Macleod AD (2000) Ondansetron in multiple sclerosis. J Pain Symptom Manag 20(5):388–391CrossRef Macleod AD (2000) Ondansetron in multiple sclerosis. J Pain Symptom Manag 20(5):388–391CrossRef
11.
go back to reference Dimitrov DH (2009) Effect of Ondansetron, a 5-HT(3) receptor antagonist, on fatigue in 2 veterans with hepatitis C. Primary Care Companion J Clin Psychiatry 11(6):366–367 (Epub 2010/01/26) CrossRef Dimitrov DH (2009) Effect of Ondansetron, a 5-HT(3) receptor antagonist, on fatigue in 2 veterans with hepatitis C. Primary Care Companion J Clin Psychiatry 11(6):366–367 (Epub 2010/01/26) CrossRef
12.
go back to reference Theal JJ, Toosi MN, Girlan L, Heslegrave RJ, Huet PM, Burak KW et al (2005) A randomized, controlled crossover trial of ondansetron in patients with primary biliary cirrhosis and fatigue. Hepatology 41(6):1305–1312 (Epub 2005/05/26) CrossRef Theal JJ, Toosi MN, Girlan L, Heslegrave RJ, Huet PM, Burak KW et al (2005) A randomized, controlled crossover trial of ondansetron in patients with primary biliary cirrhosis and fatigue. Hepatology 41(6):1305–1312 (Epub 2005/05/26) CrossRef
13.
go back to reference Piche T, Vanbiervliet G, Cherikh F, Antoun Z, Huet PM, Gelsi E et al (2005) Effect of ondansetron, a 5-HT3 receptor antagonist, on fatigue in chronic hepatitis C: a randomised, double blind, placebo controlled study. Gut 54(8):1169–1173 (Epub 2005/07/13) CrossRef Piche T, Vanbiervliet G, Cherikh F, Antoun Z, Huet PM, Gelsi E et al (2005) Effect of ondansetron, a 5-HT3 receptor antagonist, on fatigue in chronic hepatitis C: a randomised, double blind, placebo controlled study. Gut 54(8):1169–1173 (Epub 2005/07/13) CrossRef
14.
go back to reference A’zimian M, Fallah-Pour M, Karimlou M (2013) Evaluation of reliability and validity of the Persian version of Fatigue Severity Scale (FSS) among persons with multiple sclerosis. Archiv Rehabil 13(4):84–91 A’zimian M, Fallah-Pour M, Karimlou M (2013) Evaluation of reliability and validity of the Persian version of Fatigue Severity Scale (FSS) among persons with multiple sclerosis. Archiv Rehabil 13(4):84–91
15.
go back to reference Krupp L (2006) Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease. Multi Scler 12(4):367–368 (Epub 2006/08/12) CrossRef Krupp L (2006) Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease. Multi Scler 12(4):367–368 (Epub 2006/08/12) CrossRef
16.
go back to reference Cohen RA, Fisher M (1989) Amantadine treatment of fatigue associated with multiple sclerosis. Arch Neurol 46(6):676–680 (Epub 1989/06/01) CrossRef Cohen RA, Fisher M (1989) Amantadine treatment of fatigue associated with multiple sclerosis. Arch Neurol 46(6):676–680 (Epub 1989/06/01) CrossRef
17.
go back to reference Taus C, Giuliani G, Pucci E, D’Amico R, Solari A (2003) Amantadine for fatigue in multiple sclerosis. Cochrane Database Syst Rev 2:CD002818 (Epub 2003/06/14) Taus C, Giuliani G, Pucci E, D’Amico R, Solari A (2003) Amantadine for fatigue in multiple sclerosis. Cochrane Database Syst Rev 2:CD002818 (Epub 2003/06/14)
18.
go back to reference Pucci E, Branas P, D’Amico R, Giuliani G, Solari A, Taus C (2007) Amantadine for fatigue in multiple sclerosis. Cochrane Database Syst Rev 24(1):CD002818 (Epub 2007/01/27) Pucci E, Branas P, D’Amico R, Giuliani G, Solari A, Taus C (2007) Amantadine for fatigue in multiple sclerosis. Cochrane Database Syst Rev 24(1):CD002818 (Epub 2007/01/27)
Metadata
Title
Comparison of the effects of amantadine and ondansetron in treatment of fatigue in patients with multiple sclerosis
Authors
Mojtaba Khazaei
Ashkan Karevan
Mohammad Taheri
Soudeh Ghafouri-Fard
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
Clinical and Translational Medicine / Issue 1/2019
Electronic ISSN: 2001-1326
DOI
https://doi.org/10.1186/s40169-019-0239-4

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