MS Day Fatigue What are you doing about it

Susan Hourihan: Q & A
Modafinil – far more helpful drug than Amantadine, but it is not in the draft NICE guideline? We can no longer recommend Modafinil, because the European Medical Agency (EMA) issued a warning about side effects of Modafinil. So, we no longer talk about or prescribe Modafinil as the primary treatment for fatigue in MS as the EMA NICE guidelines it can only be prescribed for narcolepsy, so we cannot prescribe it anymore. However, there are many people who had Modafinil prescribed prior to this guidance, and if they are closely monitored by their GPs and GPs prescribe it, then its ok, but we cannot recommend it any longer.

‘Vivid dreams’ - how it was identified and how significant its effect was?
Vivid dreams really only relate to the side effects of the medication Amantadine. It was discovered within the trials and use of the drug. It’s quite a rare side effect but it can occur. So sometimes people find it difficult to fall asleep or stay asleep. Therefore the recommendation is, if you are taking a 2nd dose, to try and take the drug before 2 o’clock in the afternoon which reduces the impact on sleep later and this seems to limit this side effect.