Page 18 - AN-3-2

Advanced Neurology

REVIEW ARTICLE
Fatigue: Pharmacological and

non-pharmacological management in patients
with multiple sclerosis

Kubra Yeni*

Department of Nursing, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey

Abstract

Multiple sclerosis (MS) is a neurological disease that causes inflammation and
demyelination of the central nervous system. It progresses with episodic attacks and
is particularly disabling in young adults. Among the many symptoms experienced
by MS patients, fatigue is one of the most commonly reported. Approximately 75
– 90% of patients experience fatigue, with the vast majority reporting it as one of
their top three symptoms. Over half of MS patients find fatigue to be a debilitating
symptom that interferes with their work, family, and social life, significantly affecting
their overall quality of life. Despite its prevalence, fatigue is often overlooked
due to its subjective nature. Although the pathophysiology of fatigue is not fully
understood, it has been associated with various variables such as stress, vigorous
exercise, anxiety, depression, insomnia, pain, spasticity, medication side effects,
anemia, and temperature elevation. Effective management of multifactorial fatigue
requires a multidisciplinary approach, incorporating both pharmacological and non-
*Corresponding author: pharmacological modalities. An analysis of studies conducted over the last decade
Kubra Yeni indicates that the efficacy of pharmacological methods is controversial, with a high
(kubra.yeni@omu.edu.tr) side effect profile. Among non-pharmacological methods, exercise has proven to
Citation: Yeni K. Fatigue: be one of the most effective interventions. In addition, dietary modifications and
Pharmacological and non- vitamin supplementation have demonstrated effectiveness. Cognitive behavioral
pharmacological management in therapy, acupressure, acupuncture, the application of cooling garments, transcranial
patients with multiple sclerosis. Adv
Neuro. 2024;3(2):2576. stimulation, web-based education and counseling, and guided imagery have also
doi: 10.36922/an.2576 reported positive results. However, further studies with larger sample sizes are
Received: December 29, 2023 necessary to objectively evaluate their effectiveness. In conclusion, fatigue is a
prevalent symptom among MS patients. While the management of fatigue through
Accepted: March 20, 2024
pharmacological methods remains controversial, non-pharmacological methods
Published Online: May 30, 2024 have demonstrated effectiveness, are low-cost, and have no side effects.
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the Keywords: Multiple sclerosis; Fatigue; Pharmacological management; Non-
Creative Commons Attribution pharmacological management
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited.
1. Introduction
Publisher’s Note: AccScience
Publishing remains neutral with Multiple sclerosis (MS) is a neurological disease that causes inflammation and
regard to jurisdictional claims in
published maps and institutional demyelination of the central nervous system. It progresses with episodic attacks and is
affiliations. particularly disabling in young adults, typically affecting those between the ages of 20 and

Volume 3 Issue 2 (2024) 1 doi: 10.36922/an.2576