Management options in multiple sclerosis-associated fatigue

Expert Opin Pharmacother. 2012 Feb;13(2):207-16. doi: 10.1517/14656566.2012.647767. Epub 2012 Jan 6.

Abstract

Introduction: Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease of the CNS. Its characteristic early clinical course includes exacerbations and remissions of neurologic disability. Fatigue is one of the most common symptoms of MS and is associated with a reduced quality of life; it is described as the worst symptom of the disease by 50 - 60% of patients. Yet, due to limitations of available evidence, current therapeutic approaches for treating fatigue are based mainly on preliminary studies and expert consensus.

Areas covered: This review summarizes current knowledge on the physiopathology, diagnosis and therapeutic options for MS-associated fatigue, including both pharmacological and non-pharmacological strategies.

Expert opinion: Large, rigorously designed trials can provide more reliable results on the efficacy of interventions for fatigue, their functional impact on everyday activities and patient quality of life. Future research should also address a better understanding of the physiopathologic mechanisms of fatigue and the development and validation of objective assessment tools to be used together with patient self-ratings.

Publication types

  • Review

MeSH terms

  • Behavior Therapy
  • Central Nervous System Stimulants / therapeutic use
  • Dopamine Agents / therapeutic use
  • Exercise Therapy
  • Fatigue / diagnosis
  • Fatigue / etiology
  • Fatigue / physiopathology
  • Fatigue / therapy*
  • Humans
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / therapy*

Substances

  • Central Nervous System Stimulants
  • Dopamine Agents