When to start meds for fatigue?

[TheMiddleWay]

My doctor just prescribed Amantadine. It was sort of offered to me off-hand with the comment that he offers it to all MS patients with fatigue. He’s a new doctor, so I didn’t really get into much discussion with him about it.

I’m torn about taking it. I work full-time and I can almost always get through a full day. But there are plenty of days that I spend the afternoon really wishing I could take a nap. There are also plenty of mornings where I feel like I could stay in bed and never get enough sleep, but can force myself to get up and get to work.

I feel like since I can tough it out, I should avoid taking another medication. On the other hand, I’m not sure if I should be forcing myself to tough it out, when there are meds that might help. Does anyone have any thoughts? How did you decide it was time to try a medication for fatigue?

[misslux]

Here's my two cents.

There is no cure for MS, so why tough it out when you don't have to?

[James1123]

I AM NOT SURE ABOUT THAT PARTICULAR MEDICATION, BUT I AM TAKING PROVIGIL FOR FATIGUE. I HAVE ONLY BEEN ON IT A FEW DAYS, BUT I CAN ALREADY TELL A 100% DIFFERENCE FROM HOW I USED TO FEEL ABOUT 2 OR 3 IN THE AFTERNOON. MY DAYS USED TO BE TOTALLY DISRUPTED AND I COULD ONLY GET A FEW CERTAIN THINGS DONE EVERY DAY. NOW I CAN GET A LOT MORE THINGS DONE AND I JUST FEEL GOOD. I AM NOT A BIG FAN OF USING MEDICATION TO TREAT EVERY LITTLE THING, BUT FATIGUE IS SUCH A BIG ONE, AND NOW I FEEL SO MUCH BETTER, THAT I WOULDN'T GO ANOTHER DAY WITHOUT MEDS TO TREAT IT. HOPE MAYBE THIS HELPS AND GOOD LUCK.

[Marco]

I'm glad your doctor seems to be taking a holistic look at your health and not just symptoms you are actively complaining about. To me, it sounds like an energy boost would allow you to get through the day with less wear and tear on your body. There was a HORRIBLE time in life where my body was overtaxed and stressed and my quality of life was horrendous. I was literally killing myself for a paycheck and I am still paying for the long-term consequences for those decisions.

I would talk to my doctor about other options, before starting a new drug. Is there another medication that you can take "as needed" and not all the time. I've never had a RedBull or other energy drink, but does something like that have a smaller footprint and bigger impact? What about b12 injections or a more natural remedy? I always advocate lifestyle changes where possible over a new medication. Can you reduce weight, exercise, change your diet or in any other way keep from taking another pill?

Finally, I would do an Amantadine trial and see how your body responds. Even if you determine you don't need the Amantadine today, you might in the future. Starting Amantadine doesn't mean you have to stay on it. but at least you'll understand the real benefits, if any. That information may help your quality of life today or extend your working years in the future. Better yet, it may help you conserve energy for more important thing in life besides surviving the work day.

[Nenee36]

fatigue

hi.........I've been told I have MS after plaque lesions were found on a brain MRI and waiting on my apt with a MS neurologist. Headaches and MAJOG fatigue is 2 of my worst comlaints.....I so hope a doctor can give me something to help with this terrible fatigue...I am not functioning as a normal person right now due to feeling so tired....I cannot fight this awful fatigue.......I garee with what poster #2 said......I am sure hoping for medication to help my fatigue.....

[Bob698]

My doctor just prescribed Amantadine. It was sort of offered to me off-hand with the comment that he offers it to all MS patients with fatigue. He’s a new doctor, so I didn’t really get into much discussion with him about it.

I’m torn about taking it. I work full-time and I can almost always get through a full day. But there are plenty of days that I spend the afternoon really wishing I could take a nap. There are also plenty of mornings where I feel like I could stay in bed and never get enough sleep, but can force myself to get up and get to work.

I feel like since I can tough it out, I should avoid taking another medication. On the other hand, I’m not sure if I should be forcing myself to tough it out, when there are meds that might help. Does anyone have any thoughts? How did you decide it was time to try a medication for fatigue?

In my case, MS fatigue came on pretty strong to the point where if I didn't lay down quick I was going to fall down.

My Neuro wanted me to try Amantadine first and it worked better than I expected. It didn't fry me out, it just took away the fatigue.

You don't have to take it every day (although it might take a couple of days to feel the effect). Now-a-days, I rarely need it but I keep the Rx current in case I do.

The only bad side effect I had was that after several days, it tended to bind me up like I was eating concreat and epoxy for dinner*. That was me, though.

Amantadine is usually a "try this first" med because its pretty safe and non habit forming, it just does its thing for somewhere between 1/3 and 1/2 of us fatigue sufferers. You don't have to worry about building a tolerance or crashing if you stop. Just take it as/when needed.

Just give it three days to a week to figure out if works for you.


*Amantadine is really an anti-viral med. No one is sure yet why it works for many of us with MS fatigue- it just does.

[justacowgirl]

I am currently taking a rx amphetamine for weight loss. I can't tell you what a difference it has made in my fatigue. I would never have believed the difference in my attitude.

I say try it. You have a disease; do what you need to live your life to the fullest.

When I am done with this I fully intend to permanently take something else for fatigue. I like feeling more like myself!!

J

[Pkar2]

I was curious about this drug, for myself, after you mentioned what it was for so I did some research. I will share:

Off-label uses

Amantadine is frequently used to treat the chronic fatigue often experienced by patients with multiple sclerosis.[9] Additionally, there have been anecdotal reports[10] and a small number of pilot studies[11][12] that show low-dose amantadine as a potential treatment for ADHD. Limited data has shown that amantadine may help to relieve SSRI-induced sexual dysfunction.[13][14][15]

Some open-label uncontrolled studies have found it to possess value as an adjunct to antidepressant therapy.[16]
Adverse effects

Amantadine has been associated with several central nervous system (CNS) side effects, likely due to amantadine's dopaminergic and adrenergic activity, and to a lesser extent, its activity as an anticholinergic. CNS side effects include nervousness, anxiety, agitation, insomnia, difficulty in concentrating, and exacerbations of pre-existing seizure disorders and psychiatric symptoms in patients with schizophrenia or Parkinson's disease. The usefulness of amantadine as an anti-parkinsonian drug is somewhat limited by the need to screen patients for a history of seizures and psychiatric symptoms.

Rare cases of severe skin rashes such as Stevens Johnson Syndrome[17] and suicidal ideation in patients treated with amantadine have also been reported.[18][19]

Livedo reticularis is a possible side effect of amantadine use for Parkinson's disease.[20]

[Bob698]

When I am done with this I fully intend to permanently take something else for fatigue. I like feeling more like myself!!

J

My fatigue lasted for several years (pre-DX) then it just faded away.
I'm not sure if that was due to my DMD in conjuntion with the Amantadine or if the fatigue just burned itself out on its own. Whatever, I'll take it and smile.

Just be careful with Rx stimulants for the long haul.

Amantadine isn't a stimulant. Its in that "we don't know why but it works" catagory and it doesn't carry the same baggage as stims.

BTW, for everyone. The typical dosage for Amantadine is between one and (a maximum of) three pills per day. As with ANY Rx med, FOLLOW YOUR DR'S ORDERS.