A recent study led by the University of Michigan has found that both medication and cognitive behavioral therapy (CBT) can help reduce fatigue in people with multiple sclerosis (MS).
Fatigue is one of the most common and disabling symptoms of MS, affecting up to 90% of patients worldwide.
The clinical trial involved over 300 adults with MS whose fatigue was interfering with their daily lives.
Researchers compared the effects of modafinil, a medication used to treat sleepiness, and CBT, a type of therapy that helps people manage their thoughts and behaviors.
The study aimed to find out how well these treatments work individually and in combination to reduce MS-related fatigue.
Over 12 weeks, both treatments—modafinil and CBT—were found to significantly reduce fatigue in participants.
Surprisingly, combining the two treatments did not result in better fatigue outcomes than using either treatment alone. The results of the study were published in The Lancet Neurology.
“Fatigue is a major challenge for people with multiple sclerosis, yet there has been uncertainty about the best treatments to reduce this symptom,” said Dr. Tiffany J. Braley, the lead author of the study.
“Our research shows that both modafinil and CBT can effectively reduce fatigue, offering new hope for managing this difficult symptom.”
In the study, more than 60% of participants in each group saw meaningful improvements in their fatigue levels. This was measured using a survey called the Modified Fatigue Impact Scale. Participants who received only CBT maintained lower fatigue scores even 12 weeks after the treatment ended, showing the long-term benefits of this therapy.
CBT, which was delivered over the phone in this study, teaches skills to manage fatigue and improve sleep habits. Dr. Anna L. Kratz, co-leader of the study, emphasized that offering CBT through telehealth could make it more accessible to MS patients who may not have easy access to in-person therapy.
The researchers also found that a person’s sleep habits, known as “sleep hygiene,” affected how well the treatments worked. Those with poor sleep hygiene responded better to CBT, while those with good sleep hygiene had better results with modafinil.
Dr. Braley noted that it’s important to consider a patient’s sleep quality when choosing treatments for fatigue. “For people with MS who struggle with sleep issues, behavioral treatments like CBT may be the better option, as wake-promoting medications could make sleep problems worse.”
This study highlights the importance of personalized treatment plans for MS patients and provides valuable insights into managing fatigue effectively.
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