Hayley Kum: The Use of Amphetamines for Improving Cognitive Impairment in Patients with Multiple Sclerosis

The Use of Amphetamines for Improving Cognitive Impairment in Patients with Multiple Sclerosis

ABSTRACT

Background: Multiple sclerosis (MS) is an autoimmune disorder that results in debilitating cognitive impairment in 40-65% of patients. There are no current treatments for this symptom of MS. This is a systematic review of literature on the impact amphetamines have on cognitive function of MS patients.

Methods:  An exhaustive search of available medical literature was conducted using MEDLINE-Ovid, MEDLINE-PubMed, Web of Science, and CINAHL. Keywords used included: amphetamines and multiple sclerosis. Relevant articles were assessed for quality using GRADE.

Results:  Three studies have statistically significant improvements in some aspects of cognitive function in patients on amphetamines when compared to placebo. However, a high rate of adverse events were noted with L-isomer or D-isomer amphetamines alone.

Conclusion:  Amphetamines positively impact cognitive function in MS patients. Mixed amphetamine salts extended release (MAS-XR) seemingly have the lowest rate of adverse effects with the greatest benefit per the Morrow & Rosehart study. Further research is needed to integrate this into a clinical setting.

Keywords: Amphetamines, multiple sclerosis

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REVIEWED STUDIES:

Morrow SA, Kaushik T, Zarevics P, et al. The effects of L-amphetamine sulfate on cognition in MS patients: Results of a randomized controlled trial.J Neurol. 2009;256(7):1095-1102.

Morrow SA, Smerbeck A, Patrick K, Cookfair D, Weinstock-Guttman B, Benedict RH. Lisdexamfetamine dimesylate improves processing speed and memory in cognitively impaired MS patients: A phase II study.J Neurol. 2013;260(2):489-497.

Morrow SA RH,. Effects of single dose mixed amphetamine salts – extended release on processing speed in multiple sclerosis: A double blind placebo controlled study. Psychopharmacology (Berl).2015 Aug 21.

AUTHOR: Hayley Kum is currently completing her second year in the School of PA Studies at Pacific University, Oregon.  She will graduate with an MS degree in August, 2016.