Cognition and fatigue in multiple sclerosis: Potential effects of medications with central nervous system activity

Abstract

Abstract-To evaluate the potential effects of medications with central nervous system (CNS) activity on cognitive function and fatigue in multiple sclerosis (MS), we performed a retrospective analysis of medication use among 70 subjects with MS who were participating in a clinical trial for evaluation of the effects of yoga and exercise programs on cognition and fatigue. Among these MS subjects, 74% were taking at least one potentially CNS-active medication. These 70 subjects were divided into two groups: those taking at least one CNS-active medication (n = 52) and those not on any medications with potential CNS activity (n = 18). We compared assessments of cognitive function and fatigue using an analysis of covariance. MS subjects on CNS-active medication had greater impairment on measures of processing speed, sustained attention, and fatigue than those not on these medications. While these findings do not establish a causal relationship between medication use and cognitive impairment and fatigue, the data indicate that researchers need to control for use of CNS-active medications when conducting studies of cognitive impairment and fatigue in MS subjects.

Medication use is associated with fatigue in a sample of community-living individuals who have a spinal cord injury: a chart review

“…In one study, Oken et al 6 suggest that central nervous system (CNS)-active medications had a statistically significant influence on the general fatigue levels of individuals with multiple sclerosis. In our study, we classified medications as fatigue causing versus non-fatigue causing.…”

“…Moreover, many individuals with SCI are often on several medications that may contribute to fatigue. 5 There is limited research on the influence of medications on fatigue in SCI and most literature simply reports the number of medications 5,6 or a select list of known fatiguecausing medications. 5 This is a relatively crude and limited approach to measuring the impact of this potentially important variable.…”

Postural control in women with multiple sclerosis: Effects of task, vision and symptomatic fatigue

“…of the day [12], is shown to interfere with activities of daily living in MS [13][14][15]. Nilsagard et al [3] found an association between perceived fatigue and falling, thus highlighting the potential effect of fatigue on balance control.…”

Cognitive impact of anticholinergic medication in MS: Adding insult to injury?

“…A previous study (Oken et al, 2006) explored potential cognitive side-effects of a wider range of medication, considered to have CNS activity; it suggested a negative impact on processing speed, sustained attention and fatigue in MS patients. Another small study compared the cognitive impact of oxybutinin versus tolterodine in MS patients, using PASAT scores as a primary outcome.…”