Indications for symptomatic treatment: fatigue

Fatigue is a common complaint in patients affected by multiple sclerosis. I ts mechanisms are poorly understood and are likely diverse. The term "fatig ue" has been used for asthenia at rest but also for fatigability during exe rcise. Amantadine is the only drug that has a proven therapeutic benefit in randomized, double blind, controlled trials. Inhibitors of serotonin re-up take are used pragmatically because of the relationship between fatigue and depression. Aminopyridins may improve fatigability, mainly at the level of lower limbs.