Treatment of multiple sclerosis with lofepramine, L-phenylalanine and vitamin B(12): mechanism of action and clinical importance: roles of the locus coeruleus and central noradrenergic systems

Med Hypotheses. 2002 Nov;59(5):594-602. doi: 10.1016/s0306-9877(02)00261-x.

Abstract

In a randomized, placebo-controlled double-blind trial a combination of lofepramine, phenylalanine and vitamin B(12) was found to be effective in relieving the symptoms of multiple sclerosis (MS). The effect occurred within 2-4 weeks, and improved all types of symptoms in all types of MS. The combination was also effective in relieving symptoms in patients with chronic pain and chronic fatigue. We hypothesize that the action of this combined therapy may relate to activation of the noradrenergic locus coeruleus/lateral tegmentum (LC/LT) system which has the potential to influence the functioning of large areas of the brain and spinal cord.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adrenergic Fibers / drug effects
  • Adrenergic Fibers / physiology
  • Adrenergic Uptake Inhibitors / administration & dosage
  • Adrenergic Uptake Inhibitors / pharmacology
  • Adrenergic Uptake Inhibitors / therapeutic use*
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / pharmacology
  • Antidepressive Agents / therapeutic use*
  • Chronic Disease
  • Double-Blind Method
  • Drug Therapy, Combination
  • Fatigue Syndrome, Chronic / drug therapy
  • Humans
  • Locus Coeruleus / drug effects
  • Locus Coeruleus / physiopathology*
  • Lofepramine / administration & dosage
  • Lofepramine / pharmacology
  • Lofepramine / therapeutic use*
  • Methylation
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / physiopathology
  • Norepinephrine / physiology*
  • Pain / drug therapy
  • Phenylalanine / administration & dosage
  • Phenylalanine / therapeutic use*
  • Severity of Illness Index
  • Stroke / drug therapy
  • Stroke Rehabilitation
  • Tegmentum Mesencephali / drug effects
  • Tegmentum Mesencephali / physiopathology*
  • Treatment Outcome
  • Vitamin B 12 / administration & dosage
  • Vitamin B 12 / therapeutic use*

Substances

  • Adrenergic Uptake Inhibitors
  • Antidepressive Agents
  • Phenylalanine
  • Lofepramine
  • Vitamin B 12
  • Norepinephrine