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Title of Journal: J Neurol

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Abbravation: Journal of Neurology

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Springer-Verlag

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DOI

10.1016/0167-6687(94)90716-1

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1432-1459

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Modafinil for Parkinson’s disease fatigue

Authors: Hilary L Tyne Joanne Taylor Gus A Baker Malcolm J Steiger
Publish Date: 2009/10/20
Volume: 257, Issue: 3, Pages: 452-456
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Abstract

Fatigue is common in Parkinson’s disease PD occurring in up to 42 of patients 2 There is no recognized treatment This is a study of modafinil for Parkinson’s disease related fatigue Ethical approval was given Patients with idiopathic PD were recruited from a Movement Disorders clinic Those with depression dementia and other causes for fatigue were excluded Patients were assessed using the Fatigue Severity Scale FSS Hospital Anxiety and Depression Scale HADS selfrating of improvement Epworth Sleepiness Scale ESS and UPDRS Modafinil was titrated up over 4 weeks to maximum of 400 mg/day There followed a 5 week maintenance phase before reassessment Thirteen patients participated No significant change was seen in any safety measure The FSS did not change significantly however those on modafinil rated an improvement in their fatigue compared to placebo The Modafinil group had a statistically significant improvement on ESS p  005 This is a small study of modafinil in selected PD patients There is a suggestion of improvement on the global clinical impression scale for fatigue but no significant change on FSS A larger study is needed to further evaluate this drug in PD fatigue This study highlights the problems with recruitment when trialing treatments of nonmotor symptoms in PD A significant improvement in EDS was seen

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