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[1] Harran Uni. Medicine Faculty, Department of Biophysics [2] Harran Uni.Medicine Faculty, Department of Radiology [3] Dicle Uni. Medicine Faculty, Department of Physiology.
Hyperactivity-impulsivity. Ms G reported being in psychotherapy. Prior trials of psychotropic therapy had failed to produce a therapeutic effect. Before initiating modafinil, the Modified Fatigue Impact Scale MFIS ; score was 76 Cognitive 37, Physical 31, and Psychosocial 8 the maximum MFIS score is 84, with higher scores indicating greater impairment. In spite of significant symptoms, the patient had insight, was well compensated, and maintained a high level of functioning. After 3 weeks of treatment with modafinil 50 mg every morning, the MFIS score was reduced to 43 Cognitive 22, Physical 16, and Psychosocial 5 ; . The patient reported an improvement in concentration, fatigue, and motivation. She has continued treatment with modafinil 50 mg taken every morning for the past 2 years. Since receiving modafinil treatment, Ms G's overall clinical condition has improved from mildly ill at baseline to normal, not at all ill, after modafinil treatment. She has tolerated the medication well. DISCUSSION The patients included in the current retrospective chart review exhibited a broad range of psychiatric and general medical conditions. Nonetheless, they shared common treatment-resistant hypoarousal symptoms characterized by some combination of excessive sleepiness, fatigue, cognitive impairments, and poor motivation. The response rate reported here is similar to the 84% response rate recently reported by Cochran in a series of 25 patients with fatigue associated with neurological illnesses who were treated with modafinil28 and consistent with the findings of Markovitz et al in open-label study of 27 patients with depression who experienced lethargy and or apathy and had either no response or a partial response to antidepressant therapy 81% of patients demonstrated improve, because demerol.
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