Methylphenidate may improve mental fatigue in individuals with multiple sclerosis: A pilot clinical trial

Fatigue is the most common symptom in multiple sclerosis (MS), previously attributed to dopamine imbalance. Evidence suggests that methylphenidate, a psychostimulant that increases striatal and prefrontal dopamine levels, is effective in reducing fatigue in various disorders. However, its effect on state vs. trait mental fatigue in MS is yet to be examined. This pilot study investigates the efficacy of methylphenidate on decreasing self-reported mental fatigue in 12 individuals with MS in a double-blind, placebo-controlled, cross-over randomized clinical trial. Our results show that “state”, but not “trait” MS-related fatigue, was reduced after 4 weeks of methylphenidate administration as compared to placebo.