Table 2.
Summary of clinical trials of symptomatic therapies
| Intervention | N | Follow- duration |
Domains assessed |
Result | Statistically significant |
Problems |
|---|---|---|---|---|---|---|
| Cognitive rehab computerized (RehaCom) [37]. |
25 | 1 year | Executive function |
Improved > control |
Yes | |
| Cognitive rehab computerized MAPSS-MS [38] |
51 | 5 months | Verbal learning |
Improved > control |
Yes | |
| Use of strategies |
Improved > control |
Yes | ||||
| Story memory technique [39] |
29 | 5 weeks | Verbal learning |
No difference |
No | |
| Verbal learning among those with moderate- severe impairment |
Treatment > Placebo |
Yes | Not primary outcome or preplanned analysis |
|||
| Stimulants | ||||||
| Methylpehindate[40] | 26 | 1 hour | Sustained attention (PASAT) |
Treatment > Placebo |
Yes | |
| L-amphetamine 15mg, 30mg, 45 mg[41] |
19 | 2 hours | visual processing speed and working memory |
Treatment > placebo Significant dose response |
Yes | Cross-over design not fully controlled for carryover effect |
| Episodic memory |
No difference |
Yes | ||||
| L-amphetamine 30mg[42] |
155 | 29 days | visual processing speed and working memory |
No difference |
||
| Verbal memory |
Treatment > placebo |
Yes | Not primary outcome |
|||
| Visual memory |
Treatment > placebo |
Yes | Not primary outcome |
|||
| Modafinil[46] | 23 | 4 months | Visual processing speed and working memory |
Treatment > no treatment |
Yes | Not placebo controlled |
| Modafinil[47] | 121 | 8 weeks | Visual processing speed and working memory |
Mixed | Y | Treatment improved > placebo on PASAT while placebo improved more than treatment on SDMT |
| Cholinesterase inhibitors |
||||||
| Rivastigmine[43] | 16 | 2.5 hours | Visual processing speed and working memory |
Treatment > placebo |
Yes | |
| Donepezil pilot[44] | 69 | 24 weeks | Verbal memory |
Treatment > placebo |
Yes | |
| Donepezil multicenter[45] |
120 | 24 weeks | Verbal memory |
No effect | ||
| Memantine [48] 30mg day |
19 out of 60 planned |
Verbal memory |
Suspended early because of severe side effects |
|||
| Memantine [49] 20mg daily |
110 | 12 weeks | Verbal memory |
No effect | Non-specific neurological side effects more common in memantine group |
|
| Sustained attention |
No effect | |||||
| Verbal fluency |
No effect | |||||
| Executive function |
No effect | |||||
| Ginkgo 120 mg twice a day pilot[50] |
38 | 12 weeks | Verbal memory |
No effect | ||
| Sustained attention |
No effect | |||||
| Verbal fluency |
No effect | |||||
| Executive function |
Ginkgo improved > placebo |
Yes | ||||
| Ginkgo 120 mg twice a day multicenter[51] |
110 | 12 weeks | Verbal memory |
No effect | ||
| Sustained attention |
No effect | |||||
| Verbal fluency |
No effect | |||||
| Executive function |
No effect | |||||
| Yoga and exercise [52] |
69 | 6 months | Alertness | No effect |