Modafinil Reduces Fatigue in Patients With Fibromyalgia

Discussion in 'Fibromyalgia Main Forum' started by JLH, Jun 4, 2006.

  1. JLH

    JLH New Member

    Modafinil Reduces Fatigue in Patients With Fibromyalgia.....

    May 22, 2006 - Modafinil (Provigil), a drug first developed for the treatment of narcolepsy, alleviates some of the fatigue that patients with fibromyalgia experience, according to a presentation today at the American Psychiatric Association's 2006 annual meeting in Toronto.

    "We were impressed with the drug's ability to relieve fatigue in other areas, such as depression, anxiety, multiple sclerosis, and Parkinson's disease, so it made sense that it would be a very good drug for alleviating symptoms of fatigue in fibromyalgia patients," presenter Dr. Thomas L. Schwartz told Reuters Health.

    In addition to narcolepsy, modafinil is approved by the US Food and Drug Administration for use in obstructive sleep apnea/hypopnea syndrome and shift work sleep disorder.

    Dr. Schwartz and his associate, Dr. Susan M. Chlebowski at SUNY Upstate in Syracuse, New York, performed a chart review of 98 consecutive patients with fibromyalgia whose treatment regimen included modafinil. Dosage ranged from 200 to 400 mg/day.

    "These patients had an average baseline visual-analog score of 7 (out of 10), which indicates very marked fatigue," Dr. Schwartz said. "Modafinil reduced their fatigue levels to between 3 or 4, suggesting that it did relatively well."

    Only about one-third of patients did not benefit at all from treatment with modafinil, the researcher added.

    "The typical side effects are headache, dizziness, and nervousness," Dr. Schwartz noted. Also, "it is a low level controlled substance with a mild addiction potential, so physicians will want to be careful when using modafinil in patients with substance abuse issues."

    He pointed out that modafinil "can disrupt birth control pills." Therefore, women should be advised to use an additional contraceptive agent during modafinil treatment.

    In their meeting abstract, Dr. Schwartz and Dr. Chlebowski conclude: "In clinical practice, fibromyalgia is often treated with a complex regimen of physical therapy, psychotherapy, biofeedback and polypharmacy. Modafinil seems to be a reasonable addition to this multimodal treatment approach."

  2. cerise

    cerise New Member

    Have both ME/CFS and FM. Asked my doctor about it after my husband did some extensive online research. I have been taking it once a day for just over a month now. It may too soon to tell, but I believe it has helped.

    I'm taking Provigil. Started at 100mg and now at 200mg. I was sleeping for days on end or just unable to get out of bed no matter how much I wanted or needed to wake up, couldn't.

    Also contribute my improvement to taking FloraMax for almost a month now to get rid of the bad bacteria built up in my system. If interested check out "mycroplasma" (sp) on the internet.

    Time will tell, after all, it may just all be in my head. At least that's what SSA has told me for years now!
  3. shanel06

    shanel06 New Member

    I have FM and CFS both. My fatigue is related to the CFS, and not the FM. For the most part yes, I can tell the difference in the two.

    I've been taking modafinil for 4 years or so now. I refer to it as my morning cup o' java. I take only 100mg a day - first thing in the morning.

    Initially the results were very noticeable. I was able to get up and go to work and make it through the day without noticing the usual flu-like extreme fatigue setting in. It was almost as clear a distinction as my initial trial of ritalin (which was like an epiphany and brought tears to my eyes). At that time I was taking 2 - 100mg tablets. One first thing in the morning, a second around noon would help me break through the afternoon fatigue.

    After 4 years, the effects are slowly wearing off. I now have a new doctor, and she will only prescribe me 100mg a day. That may account for some of the wearing off affect. And, much like my response to ritalin, eventually the body will grow too used to the drug and its effectiveness will decrease.

    For me, it's been a life saver. My side effects from the meds are minimal. Most come from the fact that I do take birth control pills, and they have to be high in estrogen to counterbalance the effect of the modafinil.

    Would I advise this for people with CFS or FM in general ? Not unless you were willing to help your body in other ways to build itself up. It is a stimulant. Stimulants help you ignore your body. That is not good. And I have been recently paying very heavy consequences for ignoring my body and its symptoms.

    But if you're like me and have to work - either financially, or for your own sanity - it may be an option.

    Shannon L.
  4. Mikie

    Mikie Moderator

    I tried some samples from my doc and it made me groggy and sleepy. I had agreed to try it but because it works in the area of the brain responsible for dopamine production, I doubt I would have taken it even if it had helped with energy. That's too big a risk to me for a relatively new drug.

    Love, Mikie

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