There is insufficient evidence on the efficacy of amantadine in reducing fatigue in people with MS.
A Cochrane review 1 included 5 studies (1 parallel arms, 4 crossover trials) with a total of 272 subjects. Quality of the studies was generally poor and all trials were open to bias. All studies reported small and inconsistent improvements in fatigue, whereas the clinical relevance of these findings and the impact on patient's functioning and health related quality of life remained undetermined. The number of participants reporting side effects during amantadine therapy ranged from 10% to 57%.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison), by limitations in study quality and by inconsistency (variability in results across studies).
1. Pucci E, Branãs P, D'Amico R, Giuliani G, Solari A, Taus C. Amantadine for fatigue in multiple sclerosis. Cochrane Database Syst Rev 2007 Jan 24;(1):CD002818. [PMID:17253480]
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"Amantadine for Fatigue in Multiple Sclerosis." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/453058/all/Amantadine_for_fatigue_in_multiple_sclerosis.
Amantadine for fatigue in multiple sclerosis. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/453058/all/Amantadine_for_fatigue_in_multiple_sclerosis. Accessed March 31, 2020.
Amantadine for fatigue in multiple sclerosis. (2019). In Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited. Retrieved March 31, 2020, from https://evidence.unboundmedicine.com/evidence/view/EBMG/453058/all/Amantadine_for_fatigue_in_multiple_sclerosis
Amantadine for Fatigue in Multiple Sclerosis [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2020 March 31]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/453058/all/Amantadine_for_fatigue_in_multiple_sclerosis.
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