More Meds, More Problems in Multiple Sclerosis Patients

This article was originally published on the Specialty Pharmacy Times website.

In patients with multiple sclerosis (MS), more medications may mean more problems with fatigue and memory, the results of a recent study suggest.

The study, published in the May 2014 edition of the Journal of Psychosomatic Research, found that participants with MS who were taking 5 or more medications tended to report more memory problems and more fatigue than participants who were taking fewer drugs. Participants taking 5 or more medications also displayed poorer memory performance on several tests compared with participants receiving fewer medications, the researchers found.

Certain drugs, including amantadine and modafinil, are prescribed off-label to mitigate MS-related fatigue, researchers stated. The study results suggest that more medications may not be beneficial if patients are already taking multiple medications.

“Our results suggest that it may at times be advantageous to consider a thoughtful medication review and possible reduction in the number of daily medications for MS patients who report elevated fatigue, rather than adding another drug to his/her regimen,” the researchers wrote. “It may also be beneficial to encourage patients to engage in empirically supported behavioral therapies to treat their symptoms when polypharmacy is a concern.”

Researchers recruited 85 participants with MS from a larger study gauging treatment adherence in MS. All participants were taking disease-modifying therapy for at least 60 days prior to entering the study, and received $125 compensation as part of the larger study, the researchers noted. Participants completed a neuropsychological evaluation with questionnaires assessing their mood, fatigue, and self-reported cognition, and also provided an inventory of their current medications.

Participants taking 5 or more medications per day were considered to be “with polypharmacy,” which is consistent with polypharmacy designations used in other medical studies. Researchers noted that as-needed medications were not included in the calculations because no participants reported taking them at the time of evaluation.

Participants taking 5 or more medications tended to be older than participants taking fewer medications, had their diagnosis for a longer time, were more disabled, and had more self-reported comorbid conditions. Despite this, the associations remained significant after controlling for age, disability level, duration of diagnosis, and comorbid conditions, researchers noted.

Participants used an average of 3.72 prescription drugs daily, with approximately 30% of the sample falling into the “with polypharmacy” category. The most common comorbidities included hypertension, asthma, hypercholesterolemia, and depression.

The most commonly used medications included antidepressants, hormones, anticonvulsants, antispasmodics, and antihypertensives.

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