Modafinil for the treatment of pain-associated fatigue:
review and case report

Fishbain DA, Cutler RB, Lewis J,
Cole B, Rosomoff HL, Steele-Rosomoff R.
Rosomoff Comprehensive Pain and Rehabilitation Center,
600 Alton Road, Miami Beach, FL 33139, USA.
: J Pain Palliat Care Pharmacother. 2004;18(2):39-47


SFatigue is a symptom that is frequently found in chronic pain patients with low back pain and/or neck pain. At the present time, no specific psychopharmacological treatment for this problem has been identified. Modafinil is a wakefulness-promoting agent that the FDA has approved for the treatment of excessive daytime sleepiness associated with narcolepsy. There have been reports on the use of modafinil for the treatment of fatigue in various neurological syndromes. This literature is reviewed. As such, modafinil treatment was initiated for a patient with severe fatigue associated with chronic low back pain and neck pain. There was dramatic improvement in fatigue and associated function. This case is described. It is the first such case report in the literature. The significance of this finding to the treatment of pain-associated fatigue is discussed.

Modafinil: review
Modafinil: structure
Modafinil and serotonin
Modafinil and the marmoset
Excessive daytime sleepiness
Modafinil as an antidepressant
Modafinil versus amphetamine
Modafinil versus methylphenidate
Modafinil, amphetamine and sleep
Fatigue, sleepiness in major depression
Modafinil plus selective serotonin reuptake inhibitoes