There are non-medical treatments for fatigue related to MS:

  • A number of studies have shown that regular exercise, usually with some aerobic (cardiovascular) component, helps with MS-related fatigue. Regular exercise is also good for balance, endurance, weight loss, and well-being.
  • It is important to use the principle of energy conservation. For example, you can use "the best time of the day" by shopping in the morning and resting in the afternoon. A brief nap may be very helpful to recharge your batteries.
  • Avoid over-filling your day.
  • If you are taking medications that are causing fatigue, discuss these with your doctor; together, you and your doctor may consider reducing or eliminating these drugs.
  • If you are drinking too much or abusing drugs, consider working on stopping these behaviors.
  • Some patients are heat sensitive and have more fatigue when they are in a hot environment or are over-heated. Having air conditioning in the summer may be very helpful. Some people may also find cooling vests to be useful.

In general, if possible, it is good to avoid using medications. People with MS often take several medications. Limiting the number of medicines is good medical practice. It is also important in reducing costs. However, if fatigue continues to interfere with activities, medications may be useful. These medications may include:

  • Aspirin: A recent well-designed study showed that two regular (325 mg each) aspirins taken twice a day significantly reduced MS-related fatigue and was preferred by patients over placebo. Aspirin is inexpensive and readily available over-the-counter. However, some people are sensitive to aspirin, and others may find it causes stomach ulcers. A trial of aspirin therapy for fatigue may be a reasonable first step in medication management. Usually, the effect can be seen after a month or two. The cost runs about $4 per month.
  • Amantadine: Amantadine (Symmetrel®) is an antiviral medication that has been used in a number of studies in MS-related cases. The drug’s effect is moderate, and side effects for some people may include nausea or a skin rash. Amantadine is given as an oral dose of 100 mg twice a day, usually in the morning and again at mid-day. One to two months is long enough to get a sense of how well this medicine is working. The cost runs about $30 to $60 per month.
  • Modafinil: Modafinil (Provigil®) is a medication which has been approved by the US Food and Drug Administration to treat a sleep disorder called narcolepsy. Two studies have been done to test modafinil in treating patients with MS. One study showed a significant effect on fatigue, but the other did not. This medication costs about $150 to $200 per month. It may not be covered by prescription plans.

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