Modafinil for ALS (Amyotrophic Lateral Sclerosis)
Ever since modafinil hit the market, (Letter to J Neuropsychiatry Clin Neurosci) doctors have been using it on amyotrophic lateral sclerosis (ALS) patients, although it has never been made part of any formal recommended treatment by any authority. There have been some small clinical trials. A University of Washington study published in 2005 found reductions in sleepiness in ALS patients given modafinil. The scores on fatigue assesment tests impoved.
A study at Columbia University recently found modafinil useful in helping ALS patients improve quality of life. The researchers used a bunch of evaluation criteria, including Clinical Global Impressions-Improvement Scale, the Fatigue Severity Scale, Epworth Sleepiness Scale, Beck Depression Inventory, and visual analog scales. Many more patients taking modafinil improved that those in the control group of this blind study, and no adverse effects were found.
The Muscular Dystrophy magazine quoted the scientists who conducted the study as suggesting 200 mg per day was an appropriate dose. The study concluded with a recommendation for a larger study.
Fatigue is a huge issue for ALS patients. Surveys consistently show it is one of the biggest complaints for those with ALS and of concern for caregivers. Modafinil might be part of a palliative care regimen that includes high-frequency chest wall oscillation.
More on ALS: http://www.ojrd.com/content/4/1/3
Modafinil has also been found useful for relieving fatigue in people
with myotonic dystrophy. Measured criteria were Epworth Sleepiness Scale
(ESS), the Stanford Sleepiness Scale (SSS), and the Profile of Mood States
Modafinil treatment of fatigue in patients with ALS: a placebo-controlled study.