Fatigue in multiple sclerosis: a short clinical update

Background:to study the dimensions of fatigue in multiple sclerosis, its pathophysiology, the efficacy, tolerabilityand safety of drug and non-drug treatments and measurement of fatigue.methods: relevant articles from pubmed and google scholar search engines from january 1987 until september 2006were studied to compose a short clinical update (not a systematic review) and make the required clinical informationavailable for the clinicians.results: there is evidence that fatigue is very common in all types and stages of multiple sclerosis, but its pathophysiologyis not well explained. consequently, few drug options have been offered for its treatment. amantadine is the bestknowndrug, though its efficacy and duration of action are limited. pemoline and modafinil are alternatives and havesome effects on fatigue. dap (diaminopyridine), asa (acetylsalicylic acid), methylphenidate and fluoxetine are otherpossible options but await further confirmation. neurorehabilitation, regular exercise and cooling are confirmed to be ofvalue in ms treatment. measurement of fatigue is a complicated issue. at present fatigue does not have a laboratorymarker.conclusions: the results of this short clinical update provide guidelines for diagnosing ms-related fatigue and differentiatingit from other similar physical and psychological conditions. it also examines prescription drug options andother therapies for ms patients with fatigue