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Cog Fog Issues – Questions

  • By BenElisofon

    I just joined multiplesclerosis.net and was looking around. This is a well written and chock full of interesting information. I was curious though, as to why there was no mention of using ADHD stimulants like Ritalin, Adderall, Concerta or Vyvanse for the treatment of MS related cognitive fatigue. I have been living with this very disabling symptom since my diagnosis in April ’94.

    I have been dx since 4/94 with RRMS. I have rather significant cognitive fatigue issues from my MS…. 2+2 do not = 4. It took me 2 years to convince my neurologist to let me try Cylert for this. 18.75 mg tablets used for ADHD for many many years. It was like night and day. The fog burned off and life was real time again as opposed to being 2-3 steps behind on everything.

    When it got pulled off the market in ’04, I shifted over to Ritalin. 20 mg 3x per day…6a, 1030a & 3p. The Ritalin lasts about 6-7 hours so by the time the first dose was wearing off, the next dose was working. About 1 1/2 years ago, I tried Adderall 2x per day on advice of my current neurologist. I take this at 630a & 11a. This lasts most of the day without issue.

    I do not know what I would do without this medication. I could not keep track of my life, take part in a 3 way conversation or put together a coherent argument on something. For more info, do a Google search on Ritalin or Adderall and ms cognitive fatigue. You find some postings from different sources as well as many that I have put up asking why this has not been studied further. They are doing 2x studies, one with Vyvanse and another with a new medication labeled C105 for MS cognitive fatigue. They are both being run out of the University of Buffalo.

    Besides my personal experiences, here is a link to a paper written by the folks at the University of Buffalo entitled “Lisdexamfetamine dimesylate (Vyvanse) improves processing speed and memory in cognitively impaired MS patients: a phase II study” from 2012.

    The first paragraph reads as follows:
    Multiple sclerosis (MS) causes cognitive impairment including slowed processing speed and problems with learning and memory. Stimulants are attractive candidates for improving mental speed but carry risk of addiction and other adverse behavioral effects. Lisdexamfetamine dimesylate (LDX) is a d-amphetamine prodrug currently approved for attention deficit (hyperactivity) disorder with the potential to be better tolerated due to its prolonged clinical effect. This phase II placebo-controlled, double-blind study aimed to assess the safety and efficacy of LDX in cognitively impaired MS patients.

    http://link.springer.com/article/10.1007/s00415-012-6663-7

    Here’s an interesting presentation on MS related cognitive fatigue from 2014 MS Society in Alberta, Canada. Take a look at page 23 of this document. It talks about how amphetamines that are used to treat ADHD (Ritalin, Vyvanse, Adderall, Concerta) seem to work / are effective for treating MS related cognitive fatigue.

    http://www.msconnectionsconference.ca/wp-content/uploads/2015/03/2014-09-19_Presentation04.pdf

    Here’s a 2012 study taking about ADHD stims for cognitive fatigue.
    http://forums.phoenixrising.me/index.php?threads%2Fadhd-drugs-reduce-me-cfs-cognitive-dysfunction.20581%2F

    Here’s a National Multiple Sclerosis Society paper, while it is for physical fatigue, talks about how Ritalin can be used for treatment of MS Fatigue.

    http://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Opinion-Paper-Management-of-MS-Related-Fatigue.pdf

    Please feel free to look into this pathway for treatment of MS related Cog Fog. There is quite a bit of information out there that many doctors and patients just do not know about. If anyone has ANY questions or comments on this, please don’t hesitate to let me know. I will be more than happy to share what I know as well as other sources of information on this.

    Thank you for reading this far. I do appreciate it. I hope it is useful to you. Have a great day.

    Ben Elisofon

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  • By Erin Rush Moderator

    Welcome, Ben, and thank you so much for sharing all of that great information! Your experience with Ritalin is fascinating and I am glad it has helped you so much. I know some of our members have used Ritalin to treat cog fog. Here is a little information we have on the topic of cog fog and potential treatments — https://multiplesclerosis.net/treatment/perception-memory-problem-solving-therapies/.

    I wanted to let you know that I had to remove your email address from your post for privacy reasons. As per our community rules, we don’t allow posts containing members’ personal information, like phone numbers or email addresses. Our members are welcome to private message you and you can share your contact information that way. Thank you for your understanding.

    I hope Ritalin continues working well for you and thanks again for sharing with our community. We’re glad to have you here! Best, Erin, MultipleSclerosis.net Team Member.

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    • By Stephanie J

      Hello! My neurologist suggested Ritalin 7 years ago for my fog life I was leading. I didn’t even know what it was but I agreed because I was so tired and confused. It’s amazing how this one medicine I take 3x a day makes my days 100% better than the days I struggled through before the medicine. I felt useless and a burden now I feel empowered without feeling screwy in the head. I think anyone that success with this issue should give this avenue a shot in!

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  • By Ashley Ringstaff Moderator

    Ben,

    I am also on Adderall twice a day for fatigue/cog-fog and it really does help.

    I have gone with out taking it for one day recently, and man does it make a HUGE difference. I feel like I’m not use/help to anyone if I hadn’t taken the medication. Outsiders can tell that i’m “different” with out it also. Cog Fog is a VERY big issue for me, and has been since I was diagnosed.

    I’ve tried many different medication remedies over the years to improve my cognitive function, but i’ve had the best luck with the Adderall.

    However, I do know that all of us living with MS are all affected differently, and what works for one person… doesn’t mean it will work for the next. I do know that they have done studies in regards to the types of medications you have listed, but it’s not highly discussed within the medical community in regards to MS, in my opinion.

    Thank you for bringing up the subject on this matter.

    Best,
    Ashley Ringstaff

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  • By B2468

    I’m really glad you enjoyed the article. I have been beating this drum ever since I started on Adderall once Cylert (another ADHD stim) got pulled from the marketplace. Please feel free to pass this article along to anyone and everyone you think might have a use for these meds.

    Thanks for the comment on the article and sharing your experiences with Adderall. Feel good…

    Ben Elisofon

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