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Cognitive Impairment and drugs
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Cecili123 posted:
I have been diagnosed with MS 8 years since I was 35. Currently experiencing some cognitive issues.

What is the run-down on off-label use of the following drugs to help with cognitive impairment, specifically short-term memory and attention?
Aricept
Donepezil
Rivastigmine
Ritalin

Are there other drugs with which people have had positive results? I am in my early 40's and hoping to work another 10 years. Looking for something to abate current problems (which are notably worse due to tiredness) and slow down any progression.

Thank you.
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hackwriter responded:
Dear Cecili,

Aricept (donepezil is the generic name), which has been used in Alzheimer's treatment, performed modestly well in a very small clinical trial of 69 patients. A larger placebo-controlled trial has yet to be done. Off-label use will depend upon the recommendation of your doctor and the willingness of your insurance company to cover it for MS.

Rivastigmine is similar to Aricept, both are approved to treat dementia and MS use is dependent upon the same mentioned above.

Ritalin and adderall, approved to treat ADD/ADHD, are prescribed to MS patients to treat fatigue. Fatigue figures large in cognitive dysfunction.

As with any of our symptom and disease-modifying drugs, those mentioned above work differently for each patient. There is no way to know whether they will work for you--and whether you might experience unpleasant side effects--unless you try them.

Ask your doctor to recommend meds that treat fatigue, it might take some time to find the one that is effective. Fatigue is the most difficult symptom to treat, and most of us use "compensatory strategies" to deal with it, such as time management and rest.

Those drugs mentioned above only treat symptoms. Our disease-modifying therapies (Copaxone, Rebif, Avonex, Betaseron, Tysabri, Gilenya, and now Tecfidera) are designed to slow progression. The latest pill to be FDA-approved is Tecfidera, which had an excellent safety profile throughout the clinical trials and will be available in May. If you wish to change your therapy, discuss the efficacy and safety concerns with your neuro, as well as researching the drugs online, there's plenty of info about them.

Hope this helps.

Kim
 
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Cecili123 replied to hackwriter's response:
Kim, thank you for your response. Have my annual with my neuro next week and was trying to arm myself with some information.

Fatigue is probably a contributing factor as my life is very fatiguing due to lots of familial and professional responsibilities.

Was also hoping Dr. Lava would weigh in as I am a former patient of his and he did wonders for me with the (then) off label use of mitozantrone (sp. probably incorrect).


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