Fighting fatigue!Modafinil vs amantadine
Hello all, like a lot of us one of my biggest struggles is with fatigue. I've been taking modafinil for a few years now, and have even recently moved up to the maximum dose of 400mg a day (200mg morning and early afternoon).
It's just not quite doing the trick, though. It's helping a little bit, but I can still find myself needing to sleep each afternoon. I take B12, vitamin D and iron supplements to give me a boost (I eat a plant-based diet and was previously shown to be anaemic, but my iron levels are stable with the supplements) and am careful to eat a ton of fresh veggies, avoid processed foods, am gluten free...I've even given up caffeine to avoid the energy peaks and troughs. I get gentle exercise every day from walking my lovely dog.
My neuro and I review my other meds every 6 months to see if there's any wiggle room to see if there's anything we can take off or reduce to try and lessen the fatigue-side effects. The only other thing we seem to be left with to try is to switch the modafinil, which has previously worked but I'm no longer seeing such good results, to amantadine.
I'm reluctant to do this as I've heard that amantadine isn't as effective as modafinil. Even my neuro admits that he favours modafinil, but of course "every patient is different." I'll admit it - I'm scared to go back to having my fatigue uncontrolled. When the fatigue is free, it completely rules my life and I'm utterly useless. Does anyone have experience with both modafinil and amantadine? I'm struggling with working out what to do and I could really do with your expert help.
I’m anxious to read the Replies to this!! I was diagnosed with Narcolepsy a year or two before the MS reared it’s ugly head. My father had both too & he slept all the time. I had always considered myself an excellent sleeper - I can sleep just about anywhere at anytime & in any position. But I started taking Modafinil for the Narcolepsy. When MS was diagnosed, I was already taking Modafinil. At one point, they gave me Provigil (which Modafinil is generic for) & I did much worse. I was back on Modafinil the next month. But even on Modafinil, I sleep most of the evening away. I can wake up from a three hour nap to put on my gown, brush my teeth, & go right to bed. It would be nice to learn of something else that actually keeps you awake! Now I do drink coffee. But I could drink a large coffee & go right to sleep. I have had a Venti coffee from Starbucks late at night & gone right to bed. It would be heavenly to learn of something to actually keep you awake. When I drive, I listen to audiobooks to help me stay awake & alert. I used to eat as I drove to keep me awake, but eating is considered distracted driving now & I’ve gained too much weight anyway. So I had to find something else to keep me awake when driving. <sigh>
@tinpiskie , fatigue is the curse faced by all MSers. Modafinil does seem to be the drug of choice to help us with this problem. Otherwise, it's a case of trying to manage the situation as best we can. There may be some ideas in the following booklet :- https://support.mstrust.org.uk/file/Living-with-fatigue-2018.pdf