Cognitive Therapy, Modafinil, Combo All Beneficial for Multiple Sclerosis Fatigue

FRIDAY, Oct. 25, 2024 (HealthDay News) — Cognitive behavioral therapy (CBT), modafinil, and their combination are equally beneficial for multiple sclerosis fatigue, according to a study published in the November issue of The Lancet Neurology.

Tiffany J. Braley, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted a randomized, comparative effectiveness trial at two universities in the United States to compare CBT, modafinil, and their combination for the treatment of multiple sclerosis fatigue. A total of 336 adults with multiple sclerosis and problematic fatigue were randomly assigned to receive CBT, modafinil, or both for 12 weeks (114, 114, and 108 individuals, respectively).

The researchers found that CBT, modafinil, and combination therapy were associated with clinically meaningful within-group reductions in the Modified Fatigue Impact Scale (MFIS) of 15.20, 16.90, and 17.30 points, respectively, at 12 weeks. From baseline to 12 weeks, the change in MFIS scores did not differ between the groups; the adjusted total mean difference in MFIS change was 1.88 and 1.20 for CBT and modafinil, respectively, relative to the combination group. For modafinil-containing groups, the most common adverse events included insomnia and anxiety.

“Results of this randomized comparative effectiveness research trial of telephone-based CBT, modafinil, and combination therapy suggest that each treatment offers largely equivalent, clinically meaningful benefits for the effects of multiple sclerosis fatigue in people with multiple sclerosis, with high acceptance, good adherence, and good tolerability,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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