Treating Chronic Fatigue Syndrome (ME/CFS): Central Nervous System Stimulants - Provigil

Provigil (Modafinil) Is a central nervous system stimulant. Approved in 1998 by the FDA Provigil is a new class of wakefulness promoting drugs. It is less likely to cause jitteriness, anxiety or fatigue than traditional stimulants. It is approved to treat narcolepsy (daytime sleepiness) and its effectiveness is being examined in many diseases including multiple sclerosis, cancer-related fatigue and Parkinson’s disease

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Provigil May Work in Chronic Fatigue Syndrome (ME/CFS)  and FM Because many patients have symptoms of ADD, such as lack of attention, poor concentration and Provigil can help with this. Provigil is also prescribed for daytime sleepiness, which many chronic fatigue syndrome (ME/CFS)patients have, and obstructive sleep apnea, which some  do.

Chronic Fatigue Syndrome (ME/CFS) /Fibromyalgia Studies – one small double-blinded study found Provigil only very modestly improved cognition in ME/CFS. The authors suggested that those chronic fatigue syndrome (ME/CFS)patients with excessive daytime sleepiness may benefit.

Chronic Fatigue Syndrome (ME/CFS)  Physicians Report - Dr. Lapp reports Provigil is safe, offers little risk of habituation and improves fatigue, mental clarity, attention deficits and depression. Dr. Teitelbaum recommends Provigil for energy and daytime sleepiness (narcolepsy). Because he is unclear about its long term effects, however, he prefers Dexedrine. Dr. Natelson finds Provigil helps in about a quarter of his patients, another quarter find no improvement and sensitivity issues preclude it from being used in the remaining half. Dr. Podell also reports that Provigil is effective in a ‘significant minority’ of his patients. Dr. Bateman has found Provigil can worsen sleep in patients with disturbed sleep patterns. One drawback is the high cost. of the drug.

Chronic Fatigue Syndrome (ME/CFS)  Patients Report – Reports of Provigil's effectiveness have been mixed; some ME/CFS patients do very well, others do not. Click here to read ME/CFS patients reports.

Dose – The standard recommended dose is 200 mgs./day taken in the morning.

Side Effects – Provigil has been well tolerated in clinical studies with mild to moderate side effects such as headache, nausea, nervousness, etc. in a small percentage of patients.

Warning – Serious rash or hypersensitivity reactions may occur in a very small percentage of patients. Click here for more.

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This summary was put together by a layman with ME/CFS. It is for informational purposes only. Please discuss any information in this website with your physician.

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Lucinda Bateman, MD., 2006. “Tips and Travails of Treatment”, An abridged version of a seminar transcript of a Nov. Lecture in Auckland, New Zealand, by Pat Fero and David Thompson.

Drugs.com: Provigil

Charles Lapp, MD.,2002. HealthWatch Treatment Guide. On the Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia. ImmuneSupport

RxList, The Internet Drug Index: Provigil

Jacob Teitelbaum, 2007. From Fatigued to Fantastic 3rd ec., Avery Press.