Research into sleeping disorder drug may help multiple sclerosis patients

A University of Nottingham academic is leading a research project looking at whether a drug produced for a sleeping disorder could improve the quality of life for thousands of multiple sclerosis patients.

Professor Elemer Szabadi, in the Psychopharmacology Unit of the University’s Division of Psychiatry, has received £25,000 in grant funding from the drug company Cephalon UK Ltd to study the drug modafinil, which is marketed to treat the rare sleep disorder narcolepsy.

Narcolepsy is a malfunction of the sleep/wakefulness regulating system of the brain. One of the common symptoms is that patients suffer from an irresistible tendency to fall asleep even in unlikely circumstances, such as in the middle of a meal or a conversation.

The drug modafinil acts on the brain cells that control sleep and wakefulness and keeps the patient awake during the day without affecting their ability to sleep at night.

Modafinil has been found to work not only on sleepiness but also on extreme fatigue during the daytime, similar to that experienced by multiple sclerosis patients. The Nottingham study aims to find out whether the drug’s effectiveness in relieving the symptoms of excessive and disabling tiredness is related to its ability to relieve sleepiness and increase alertness.

The study is using three groups of subjects to test the effects of the drugs on alertness and bodily functions, such as blood pressure, heart rate and salivation, and reactions of the pupil of the eye to light and darkness. Two groups of patients suffering from MS, with fatigue and without fatigue, are being recruited through a clinic run by Professor Cris Constantinescu in the University’s Division of Neurology, and compared with a group of healthy volunteers.

In a separate study healthy volunteers are given single doses of different sedative drugs which work by affecting different areas of the brain, and their effects are compared on measures of alertness and bodily functions with the effects of a single does of modafinil. It is also looking at whether modafinil can counteract the effects of the sedative drugs when modafinil and the sedative drugs are administered together. In this way, the research team is hoping to discover on which area of the brain modafinil acts.

Professor Szabadi said that the drug could also have some benefit for patients suffering from depression who also often experience disturbed sleep and severe daytime fatigue. Sleeping tablets sometimes prescribed for these patients have a ‘blockbuster’ approach, affecting many parts of the brain, and often lead to daytime drowsiness and fail to relieve tiredness.

Professor Szabadi added: "It’s very likely that the brain cells that control sleep are also responsible for controlling other functions in the body, such as eating, sexual behaviour and autonomous activities (maintenance of blood pressure, heart rate etc) and it is known that most of these functions are affected by various psychiatric disorders.

"This study will give us the opportunity to find out more about the areas of the brain which control a number of essential functions of great relevance to psychiatry." http://www.nottingham.ac.uk