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Case Reports
. 2021 Mar 22;14(3):e240283.
doi: 10.1136/bcr-2020-240283.

Recovery from refractory chronic fatigue syndrome with CBT and modafinil

Himanshu Garg  1 , Maggie Douglas  2 , Gordon Douglas Turkington  3 , Douglas Turkington  4
Affiliations
Case Reports

Recovery from refractory chronic fatigue syndrome with CBT and modafinil

Himanshu Garg et al. BMJ Case Rep. .

Abstract

Many patients with chronic fatigue syndrome (CFS) fail to derive benefit from evidence-based treatments such as cognitive-behavioural therapy (CBT) and graded exercise therapy leading to permanent disability. To discover whether a repeat prescription of modafinil might potentiate the benefits of CBT leading to social recovery as defined by 2 or more point improvement in energy and muscular pain/concentration and return to work or full-time training. Three patients with treatment-resistant CFS (mean duration 17.66 years) treated with modafinil and CBT in a Liaison Psychiatry clinic were retrospectively reviewed. Progress was reviewed at baseline, 4-6 months and 10-24 months. Patients rated their fatigue, pain and concentration using 10-point Likert scales. 2/3 achieved clinically meaningful improvements in energy and pain/concentration and 3/3 achieved social recovery. Modafinil, when prescribed over the medium term, would appear to be a potentially useful potentiating agent when added to CBT.

Keywords: cognitive behavioural psychotherapy; psychiatry (drugs and medicines).

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Mean scores for energy, pain and concentration at baseline, 4–6 months and 10–12 months.
See this image and copyright information in PMC

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