Hi all, I have leg and arm muscles which fatigue quickly - and the muscle fatigue is now setting in faster and allowing me to do less and less. My feet now drag after walking from one end of my (small) house to the other.

I also have the sleepy, foggy fatigue which till now I've just managed with lots of 20 minute power naps! The sleepy fatigue is also getting worse - probably because the effort involved in dragging myself around has increased.

Because of this, I'm thinking of asking my neurologist to consider an anti-fatigue medication for me. Can anyone advise on whether an anti-fatigue med might help with muscle fatigue, and thus allow me to get more mileage out of my legs (well, steps anyway, I'd be happy with a few more steps!)?

Thanks

Teddy,
Do you think it's possible that you have "Restless Leg Syndrome"? Perhaps that is keeping you up at night or not allowing you to get a good nights sleep?
I take something for RLS, but I am on my feet all day, as well as taking something for general fatigue. I take Provigil for fatigue, but don't take it everyday (just the days after I've been on call, or have a heavy workload).

Also, I'm wondering if you have been examined to see if you have any type of foot drop. Perhaps an AFO might be of some help to you. Have you seen a Physical Therapist to be evaluated for any gait anomalies?

Chris

Hi Chris, I do definitely have sleep issues. I do get leg spasms if I try and sleep with my legs in certain positions, but I think the major problem is that I can no longer turn over in my sleep. So, I get uncomfortable or need to change positions and wake up to turn myself over. Sleep is also complicated by my darling but snoring husband. Once I've woken up, his snoring can keep me from falling back asleep.

I've got an ataxic gait, according to my neurologist and physio. Wide based, unco-ordinated, as well as balance issues. We've discussed foot drop previously because my left foot does drag somewhat (worse with fatigue), and she mentioned an AFO to me and has said that if things get worse that's something we should look at. Might be time to talk to her about this again, it might make my walking a bit more stable.

Thanks so much for your response. I notice from Sally's welcome post that you're a Brit - I have a half British half American husband whom I met while I was in London. We lived in Camden together for a couple of years before coming to Australia. Great fun!

Teddy:

Fatigue meds are a catch-22 for some of us in limboland. Once the meds wake us up we think we are better and tend to overdo it, making the other symptoms worse.

One of the drugs used for fatigue is Amantadine, an anti-Parkinson drug. It does not work for everyone. There are other anti-fatigue drugs used for MS patients, you neuro will help you find the best one.

Hopefully you have a neuro who is available and won't make you wait weeks for an appt., who understands you could use the meds now.

Hi Teddy,

Just wanted to mention that in clinical trials, acetyl l-carnitine was demonstrated effective in chronic fatigue syndrome and more effective than amantadine -- which as Cricket suggests, has also been demonstrated effective -- in MS fatigue.

Carnitine has also been demonstrated effective as a treatment for fatigue in MS resulting from the use of interferons or Cytoxan.

Acetyl l-carnitine is available without prescription.

Another overlooked (double-blind, placebo controlled) small clinical trial found that aspirin (1300 mg per day) was effective in treating MS fatigue.

Mark

Hi Mark

Aspirin is my favorite medication for almost everything. I use it for pain, heart, sleep, infection. It has always been very effective for me. I only take it when the need arises, however, because, like all meds, it can lose it's effectiveness and can cause stomach troubles, if taken to excess.

I had not heard that, if taken in larger quantities, asprin is also effective for MS fatigue....Since I use it, occasionally at night, to alliviate pain that keeps me awake.

Ldn usually keeps my fatigue at bay, but am happy to learn of this new use for Asprin.

Thanks,

I wonder if this might help. It's not anti-fatigue but it improves walking so I'm assuming muscle coordination or muscle strength in some way.

http://forums.braintalk2.org/showthread.php?t=1620

I took amantadine one time and it wired me up so bad I think I could have walked straight up the walls given a reason to do so.

You may be flirting with a flare up which is why you are experiencing so much fatigue and more leg probs. So you may need to rest more and not try to get a med to give you false energy, and let things level off a bit.

I know how we are. We don't want to wait but sometimes listening to your body is the kindest thing you can do.

I think trying the Acetyl Carnitine would be a good way to go though especially with the muscle problem you are having. I wish you well and wisdom in your choices. m

Thanks so much for the replies and advice everyone!

I spoke to my neuro yesterday and he very readily agreed to give me a try on Amantadine. We need to speak again in the next week or so, so I might mention acetyl l-carnitine to him and tell him I'll give that a try before I start on something like Amantadine. Thanks Mark! I notice that it's also said to help in the metabolism of fats - that would be a very handy side effect!! Mark, I notice the PubMed study used 1g twice daily - do you know if that is the dose I should be taking?

Wayleaf, you're right, I'm definitely on the back end of a flare. Was exhausted for about a month, walking went really haywire for five days and now I'm just in the exhausted phase again. I'm SO grateful that my walking has gone back to baseline. It's not the best, but I can still do it, at least!

Wannabe, Fampridine looks very promising. I'm not sure whether it's available in Australia, but I'll talk to my neuro and otherwise keep an eye out.

Thanks again, everyone.