Which medications in the drug class Stimulants are used in the treatment of Multiple Sclerosis?

Updated: Oct 08, 2019
  • Author: Christopher Luzzio, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Answer

Stimulants

Modafinil (Provigil), armodafinil (Nuvigil), dextroamphetamine (Dexedrine), and methylphenidate (Concerta, Metadate CD, Metadate ER, Ritalin, Ritalin SR) are wakefulness-promoting agents approved for the treatment of narcolepsy. These agents are also used for the treatment of fatigue without interfering with normal sleep architecture in patients with MS. Modafinil and methylphenidate have also been used as cognitive-enhancing drugs to treat cognitive dysfunction in MS.

Modafinil (Provigil)

Modafinil is listed in Schedule IV of the Controlled Substances Act. It promotes wakefulness, and is used for treatment of fatigue without interfering with normal sleep architecture. Patients should be observed for signs of use or abuse, as the drug has psychoactive and euphoric effects similar to those seen with other scheduled CNS stimulants (eg, methylphenidate). The mechanism of action of modafinil is unknown.

Armodafinil (Nuvigil)

Armodafinil elicits wakefulness-promoting actions similar to those of sympathomimetic agents, although its pharmacologic profile is not identical to sympathomimetic amines. It is indicated to improve wakefulness in individuals with excessive sleepiness associated with narcolepsy, obstructive sleep apnea–hypopnea syndrome (OSAHS), or shift-work sleep disorder. It is also used for treatment of fatigue without interfering with normal sleep architecture. It may also be used as a cognitive-enhancing drug to treat cognitive dysfunction in MS.

Methylphenidate (Concerta, Daytrana, Metadate ER, Methylin, Ritalin, Ritalin LA, Aptensio XR)

Methylphenidate is a piperidine derivative. It stimulates the cerebral cortex and subcortical structures.

Dextroamphetamine (Dexedrine, ProCentra, Zenzedi)

This agent increases the amount of circulating dopamine and norepinephrine in the cerebral cortex by blocking the reuptake of norepinephrine or dopamine from synapses.


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