Fast Five Quiz: Key Aspects of Multiple Sclerosis Treatment

Michelle H. Cameron, MD, PT, MCR; Kerstin Hellwig, MD


June 30, 2022

Intravenous methylprednisolone (1000 mg daily for 3-5 consecutive days) is administered to reduce the duration of significant MS relapses. However, methylprednisolone does not alter the frequency or risk for future relapses or slow disease progression.

Amantadine is used for treatment of fatigue in MS, but this is an off-label use. The usual dosage is 100 mg orally twice a day. A study by Pucci and colleagues reported that approximately 40% of patients with MS experience some fatigue relief with amantadine. It should be noted, however, that amantadine is used for symptom relief only and is not specifically indicated to reduce the duration of significant MS relapses. A recent randomized trial determined that amantadine, modafinil, and methylphenidate were not superior to placebo in improving MS fatigue and caused more frequent adverse events.

Antidepressants may be used adjunctively to treat depression in people with MS, but they are not specifically indicated to reduce the duration of MS exacerbations.

Learn more about acute treatment.


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