Ellagic acid favorable effects on fatigue, depression and anxiety in patients with multiple sclerosis and moderate disability: A randomized clinical trial

Background: This study aimed to evaluate the impact of ellagic acid (EA) on fatigue, depression, and anxiety in patients with multiple sclerosis (MS) who have moderate disability. Methods: A triple-blind, placebo-controlled clinical trial was conducted. Fifty-eight MS patients were randomly allocated to receive EA or placebo. Measurements of fatigue, depression, and anxiety were taken at the beginning and end of the study. Data analysis was performed via SPSS. Results: Significant improvements were observed in the EA group across several measures: the State-Trait Anxiety Inventory (STAI), the Quick Inventory of Depressive Symptomatology (QIDS), the Hospital Anxiety and Depression Scale (HADS) for both depression and anxiety subscales, and the Modified Fatigue Impact Scale (MFIS), which includes total, cognition, psychosocial, and physical scores (P < 0.001). At the end of the study, significant differences between the EA and placebo groups were noted. Within the EA group, significant changes from baseline were found in EDSS, STAI (p = 0.003), QIDS (p = 0.041), HADS-D (p = 0.032), HADS-A (p = 0.012), total MFIS (p = 0.004), MFIS-Cognition (p = 0.001), MFIS-Psychosocial (p = 0.049), and MFIS-physical (p = 0.001) scores. In the EA group, significant changes from baseline were observed in EDSS, STAI (p = 0.003), QIDS (p = 0.041), HADS-D (p = 0.032), HADS-A (p = 0.012), total MFIS (p = 0.004), MFIS-Cognition (p = 0.001), MFIS-Psychosocial (p = 0.049), and MFIS-physical (p = 0.001) scores. Conclusions: EA appears to significantly alleviate fatigue, depression, and anxiety in MS patients.