A Comparative Study of Acupuncture and Oral Amantadine in Relieving Fatigue in Patients with Multiple Sclerosis: A Randomized Clinical Trial

Background: Fatigue is a common and debilitating symptom in multiple sclerosis (MS).Despite available evidence, more general studies are needed to assess the effects of amantadine and acupuncture on MS-related fatigue (MSRF).This study aimed to compare the effectiveness of these treatments in alleviating MSRF.Methods: Sixty patients with MS aged 18-50 years with fatigue lasting > 6 months were enrolled and randomly assigned into two groups (n = 30 each).One group received 100 mg of amantadine twice daily for 2 months, whereas the other underwent ten 30-minute standardized acupuncture sessions.Fatigue and quality of life (QoL) were assessed at baseline, after the intervention, and at the 2-month follow-up using the fatigue severity scale (FSS) and the Short-Form Health Survey 36 (SF-36).Results: A total of 22 patients in the amantadine group and 27 in the acupuncture group completed the study.The mean age was 37.59 ± 7.74 years, and 79.6% were female.The FSS scores were significantly lower in the acupuncture group immediately after the intervention and at follow-up.Both interventions improved most SF-36 domains, with acupuncture yielding greater improvements in vitality, emotional well-being, and general health.Conclusion: Amantadine and acupuncture significantly alleviated MSRF and enhanced QoL.Acupuncture showed greater symptom improvement and fewer adverse effects, supporting its favorable safety and efficacy profile.However, no cost analyses were conducted; thus, economic conclusions remain limited.Further randomized controlled trials with larger samples and economic evaluations are recommended.Nevertheless, acupuncture may be a promising adjunctive therapy for alleviating MSRF.