The histaminergic system is phylogenetically one of the oldest parts of the nervous system but it is a relatively recent discovery. It is involved with several vegetative functions like sleep, attention and learning, feeding and satiety, working memory, cognition, depression, and most of all arousal and energy
1. Establish in an open label clinical trial the tolerability and safety of various doses of l-histidine and lodosyn that may increase levels of l-histidine and histamine in the serum and cerebrospinal fluid (CSF). 2. Perform pharmacokinetic studies in serum and CSF of study subjects the levels of l-histidine and histamine after treatment with various combination of l-histidine and lodosyn. 3. Preliminary information will also be collected on the effects of this intervention on alleviation of fatigue. The findings from this study go beyond the effects of histamine on fatigue. If central histamine can be increased by the strategy outlined above, a number of other vegetative hypothalamic functions intricately associated with fatigue including sleep, cognition and satiety need to be examined in MS patients in future studies.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
All subjects will receive a fixed dose of 50mg of Lodosyn twice daily.
Sequential Dose Escalation of 250mg to 500mg to 1000mg twice daily.
University of Miami
Miami, Florida, United States
Number of adverse events experienced by participants.
All adverse and serious adverse events reported during the study will be analyzed and tabulated. No quantitative statistical analysis will be performed. The primary goal of this study is to establish that this intervention is safe and possibly effective.
Time frame: 30 days
Change extent of fatigue.
At the conclusion of the study, each individual would have completed a screening and baseline visit without any intervention and two weekly visits during intervention with the study medications. The two evaluations off drug will be compared to the two evaluations on drug. A drop of the Fatigue Severity Scale (FSS) score by 1 point or more will be considered a response. Once the information is converted into a binary function of response / no response, the data is amenable to conditional logistic regression analysis.
Time frame: Screening(0 day), baseline(15 days) and final visit(30 days)
Change in Quality of life.
Multiple Sclerosis Quality of Life (MSQOL) scales will be used to measure the change in Quality of Life. Based on the scale, there will be a 0 to 100 with a higher score indicating a higher quality of life.
Time frame: Screening(0 day), baseline(15 days) and final visit(30 days)
Change of fatigue impact scale.
Modified Fatigue Impact Scale (MFIS) scale will be used to evaluate the physical, cognitive and psychosocial scores. The score ranges from 0 to 84 with a lower score, lower side effects of fatigue.
Time frame: Screening(0 day), baseline(15 days) and final visit(30 days)
Change of visual pain.
Visual analogue scale to evaluate the pain by using a numerical scale for 0 to 10 with a lower score, less visual pain.
Time frame: Screening(0 day), baseline(15 days) and final visit(30 days)
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Change of daytime sleepiness.
Epworth sleep scale to rate the probability of falling asleep during daytime on a scale of 0 to 24 with a lower score the lower the symptoms of sleepness.
Time frame: Screening(0 day), baseline(15 days) and final visit(30 days)
Change of hunger sensitivity.
Hunger Satiety Scale to determine the extent of hunger and fullness by using a 1 to 10 score range with a higher score indicating a higher hunger sensitivity.
Time frame: Screening(0 day), baseline(15 days) and final visit(30 days)