- Modafinil can reduced physical fatigue commonly seen in patients
with Parkinson's disease, researchers reported here at the 132nd
Annual Meeting of the American Neurological Association (ANA).
"It was very gratifying to find that modafinil improves physical
fatigue in patients with Parkinson's disease," reflected study
presenter Jau-Shin Lou, MD, Associate Professor of Neurology,
University of Oregon Medical School, Portland, Oregon, United
States.

Dr. Lou and colleagues undertook the study because Parkinson's
disease patients at all stages of the disease are known to have
physical fatigue. Studies have shown that more than half of patients
with Parkinson's experience physical fatigue. "This is a well-
documented phenomenon," he lamented.

"Modafinil is approved for narcolepsy and has been shown to improve
fatigue in multiple sclerosis, so we deduced that it was worth
evaluating in Parkinson's disease," said Dr. Lou.

In their study, the researchers assessed fatigue levels in 19
Parkinson's disease patients using the Multidimensional Fatigue
Inventory (MFI), a measurement tool that has been in use for about
20 years.

Nine patients who were on current Parkinson's disease treatments
were randomly assigned to modafinil 100 mg BID and 10 patients
received placebo. Finger tapping and intermittent force generation
were used to evaluate physical fatigue objectively and MFI was used
to measure fatigue subjectively. Subjects completed the Epworth
Sleepiness Scale (ESS), the Center for Epidemiologic Studies
Depression Scale (CES-D), and the multidimensional McGill Quality of
Life (MQOL).

Results showed that the modafinil group, but not the placebo group,
showed increased finger tapping frequency (P <.05), increased
tapping velocity (P <.05), less fatigue from finger tapping (P
<.05), less general fatigue in the MFI (P <.05), less fatigue from
intermittent force generation (P <.1), and less sleepiness (P <.1)
from week 1 to 8. Both groups reported improved quality of life.

Dr. Lou concluded that, "at the regular dose used in narcolepsy,
modafinil clearly reduced physical fatigue in Parkinson's disease."

He recommended that physicians prescribe modafinil to their patients
with Parkinson's disease who are suffering from fatigue.

"The agent can be used as an adjunctive medication to levodopa or a
dopamine agonist," he added.

Dr. Lou and his group hope to perform a larger trial, "but there's
no need to wait to start using modafinil," he urged.

Presented at ANA
Maggie Schwarz
Washington, DC, October 9, 2007(Doctor's Guide)