Fifteen studies (n=1,182) were included in the review: eight randomised controlled trials (RCTs); four non-randomised controlled studies; and three single-group studies.
Two studies were rated as moderate to high quality, four studies as moderate to low quality, six studies as moderate quality and three studies were rated as low quality. Eight studies lacked an adequate control group, four studies reported insufficiently precise measures of fatigue, four studies had short assessment periods or follow-up and four studies had small sample sizes.
Pharmacological studies (10 studies):
Results reported mixed evidence of effectiveness for pharmacological interventions for fatigue in participants with MS: three studies reported a significant decrease in fatigue for amantadine (p<0.01), pemoline (p=0.06) and 200mg per day doses of modafinil (p<0.01) and Prokarin (p value not reported) compared to placebo; three studies reported mixed effects for outcomes and three studies reported no statistically significant differences between groups. Five studies reported adverse events occurring during the study period (data reported in the review).
Psychosocial/psychological studies (five studies):
Five studies reported a significant decrease in fatigue for participants with MS who underwent either electromagnetic therapy, yoga, exercise, energy conservation courses or cooling therapy.