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Fatigue occurs in a majority of patients with MS and is generally independent of measurable neurologic disability.Few options for treatment are available.We conducted a double-blind,placebo-controlled,crossover trial for each of two 4-week treatment periods.Forty-six eligible patients entered and five dropped out due to concurrent exacerbations.Nineteen patients(46.3%)experienced excellent or good relief of fatigue with pemoline,and eight patients(19.5%)with placebo(p=0.06,Fisher's exact test).One-fourth of patient did not tolerate the drug well,and 7%had to discontinue pemoline during the study due to side effects.The most common side effects were anorexia,irritability,and insomnia.Pemoline may be an effective short-term treatment for fatigue associated with MS,but its adverse effects are not well tolerated by many patients. |
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