Beginners Guide to Modafinil for Chronic Fatigue

Chronic fatigue (CF) usually strikes individuals between the ages of 20 & 40. However, it also occurs in teens & children younger than 12 years old. Everyone feels fatigued at some point. You can be weary & tired — probably too tired to get motivated for important tasks or chores. But does a lack of energy mean you are on your way to developing CF? Not at all, experts say. Fatigue is extremely different from CF.

Read this guide to know the basics of modafinil & CF as well as how to use modafinil for chronic fatigue treatment. Additionally, acquaint yourself with the possible risks of using this medicine for CF & a verdict on whether modafinil does treat this condition. Let’s get started!

What Is Modafinil?

Modafinil (trade name Provigil) is a eugeroic, or a wakefulness-promoting agent, licensed by the Food and Drug Administration (FDA) for the treatment of narcolepsy, shift work sleep disorder (SWSD), & obstructive sleep apnea (OSA). This med is also regularly prescribed by physicians off-label for chronic fatigue, depression, jet lag, attention deficit hyperactivity disorder, Parkinson’s & Alzheimer’s diseases, among other conditions. It’s also often used by healthy individuals to improve mental abilities and ultimately boost productivity.

Modafinil works by affecting some brain neurotransmitters including histamine, serotonin, dopamine, orexin, & norepinephrine. Histamine supports memory, learning, happiness, & motivation and regulates aggression & quality of wakefulness [1]. Orexin is known to regulate the sleep-wake cycle [2]. Dopamine plays a principal role in how you feel pleasure, think, & plan. It also helps individuals remain motivated and focused and regulates sleep and wakefulness [3]. By increasing the levels of these chemicals, modafinil does a lot of things aside from promoting wakefulness. That’s why it’s widely used to manage fatigue. But how? Let’s find out in the next section.

The Basics About Modafinil and Chronic Fatigue

Chronic fatigue is a complex disorder characterized by intense fatigue that lasts for at least 6 months & that can’t be completely explained by an underlying medical condition. It worsens with mental or physical activity but doesn’t improve with rest. CF occurs when signs of exhaustion or lack of energy last over 6 months. It is also a symptom of many chronic health conditions, including fibromyalgia, rheumatoid arthritis, or lupus. Although the precise cause of CF is unknown, certain factors can play a role, such as hormone level changes, stress, & infection.

CF often results from sleep disorders, usually insomnia, in combination with depression & chronic pain. Besides, other factors that may contribute to the symptoms of this condition include a poor diet, physical inactivity & lack of exercise, and the intake of certain meds. Additionally, CF is often associated with decreased levels of the neurotransmitter serotonin. The latter is closely linked to fatigue because of its well-known effects on sleep, lethargy, & drowsiness as well as lack of motivation [4]. Regardless of the cause, CF impacts day-to-day functioning & quality of life in individuals with arthritis.

Although there’s no cure for CF, there are over-the-counter (OTC) & prescription meds that could be used to ease its symptoms. The most notable med is modafinil. It’s designed to help manage fatigue and problems with memory & concentration. It helps boost the levels of serotonin, among other neurotransmitters, low concentrations of which can lead to CF. Consider that meds that work for one patient might not work for another.

Physicians frequently prescribe antidepressants that boost adrenaline (epinephrine) to aid with fatigue, and certain stimulants, like Ritalin & Adderall, are rarely used. Some patients respond very well when treated with non-stimulant wakefulness-fostering agents such as modafinil & armodafinil (Provigil & Nuvigil, respectively). Nevertheless, these meds are only indicated to treat SWSD, narcolepsy, & OSA.

Tips on How to Get Rid of Chronic Fatigue with Modafinil

As stated earlier, there’s no specific cure for CF. Each patient has different symptoms & may therefore necessitate different types of treatment to manage the disorder & relieve its symptoms. Since individuals with CF are very sensitive to any meds that affect the brain, some of them experience irritation & agitation when they’re taking stimulants in conventional doses. That means such drugs should be prescribed in low doses by physicians who frequently prescribe them & comprehend how to handle the negative effects.

Because modafinil seems to be safe & effective in treating chronic fatigue, the initial dose is 200 mg that should be taken in the morning. However, the dosage can be split in two and taken in the morning & at noon. Take note that the dosage is based on a prescription. Some individuals may benefit by taking a higher dose (up to 400 mg), while others may find lower doses of 50 mg or so extremely effective.

Although there is as yet no official summary of its use in the treatment of CF, there is a case of a patient with severe CF who made a good recovery with modafinil. There is no information on whether patients with CF need to take modafinil long term. However, this drug could be used as a short-term intervention [5].

How to Get Insurance Approval for Modafinil for Chronic Fatigue Syndrome?

Eager to know how to get insurance approval for modafinil? As mentioned earlier, modafinil isn’t approved to treat chronic fatigue syndrome but is used off-label for this purpose. Thus, insurance won’t cover it because there’s no indication for chronic fatigue with the med. However, depending on the insurance company, it may require proof of your CF diagnosis to certify your claim. The problem with CF is that there’s no single test that can confirm a diagnosis. Consequently, it’s often challenging to objectively verify its symptoms. Symptoms of CF can resemble those of many other health problems, including certain sleep disorders, & CF can be caused by sleep disorders.

Your insurance company will need to understand all of your symptoms so it can better know how & why they prevent you from working. It will likely need objective evidence of symptoms and/or a diagnosis for any long-term disability.

Certainly, your diagnosis is fundamental. The first action in filing a CF long-term disability claim is to secure a legit diagnosis with your treating physician. When applying for insurance, it can be essential to confirm the CF diagnosis using the criteria set by the National Academy of Medicine, which entails the following:

• at least a 6-month history of a substantial reduction/impairment in the capacity to engage in pre-illness levels of activities followed by profound fatigue of new or specific onset that is not the result of ongoing excessive exertion & that is not essentially alleviated by rest;
• unrefreshing sleep;
• post-exertional malaise;
• orthostatic intolerance or cognitive impairment.

Certainly, the insurance company may weigh its verdict very heavily on your physician’s opinion, so your physician’s support is key [6]. Besides, the coverage of modafinil may be provided for any non-FDA labeled indication if it’s determined that its use is a medically accepted indication supported by nationally recognized pharmacy peer-reviewed medical literature or compendia for treatment of the diagnosis for which it’s prescribed. The patient insurance application is usually evaluated on a case-by-case basis to determine medical necessity [7].

Possible Risks of Taking Modafinil for Chronic Fatigue

Modafinil can be linked with some risks when used for the treatment of CF. It may cause some individuals to feel drowsy, dizzy, have trouble controlling movements, thinking, or seeing clearly. When using modafinil for this condition, make sure you know how you react to it before you operate machines, drive, or do other tasks that require you to be well-coordinated, alert, and able to think or see well.

Besides, modafinil may cause headache, nausea, nervousness, dry mouth, & insomnia. It may also trigger dyskinesias in elderly patients [8]. Talk with your physician about the possible risks of using modafinil & make sure a health analysis is carried out to determine if this medicine is good for you. Modafinil also interacts with other drugs & may cause drug-disease interaction. Always let your physician know about the meds you might be taking to determine if they can interact with modafinil.

So, Does Modafinil Treat Chronic Fatigue?

Chronic fatigue remains a complicated condition with no definite known cause & cure. The recovery rate is very low, and that is why managing the disorder can be challenging. You’ll possibly need to make lifestyle changes to adapt to your CF or apply stress management, therapy, or certain medications. As a consequence, you may experience depression, social isolation, or anxiety. CF progresses differently in everyone, so it’s essential to work with your physician to create a treatment plan that meets your needs. You may opt to use supplements for energy such as carnitine, D-ribose, reduced nicotinamide adenine dinucleotide (NADH), creatine, magnesium malate, & vitamin B12. Nonetheless, many individuals with CF remarkably benefit from taking modafinil precisely as prescribed.

Hopefully, this guide has given you great tips on using modafinil for chronic fatigue. Although this drug isn’t approved to manage the condition, it has proved very effective & well-tolerated with few to no negative effects.

References

1. Histamine H1 receptor on astrocytes and neurons controls distinct aspects of mouse behaviour. By Anikó Kárpáti, Takeo Yoshikawa, Fumito Naganuma, et al. Published: November 11, 2019. Nature.com.
2. What Are Orexins? By Madeline Laguaite. Medically reviewed by Brunilda Nazario, MD, on July 08, 2021. Retrieved: November 15, 2021. Webmd.com.
3. What Is Dopamine? By Hope Cristol. Medically reviewed by Smitha Bhandari, MD, on June 14, 2021. Retrieved: November 15, 2021. Webmd.com.
4. Physical and Emotional Symptoms of Low Serotonin. By Adrienne Dellwo. Medically reviewed by Grant Hughes, MD. Updated: May 11, 2020. Verywellhealth.com.
5. Recovery from chronic fatigue syndrome with modafinil. By Douglas Turkington, Daniel Hedwat, Iain Rider, and Allan H. Young. Retrieved: November 18, 2021. Citeseerx.ist.psu.edu.
6. Is Chronic Fatigue Syndrome/Myalgic Encephalomyelitis a Disability? Retrieved: November 18, 2021. Riemerhess.com.
7. DE Medicaid PA Criteria for Provigil (modafinil) and Nuvigil (armodafinil) (pdf). Retrieved: November 18, 2021. Fm.formularynavigator.com.
8. Chronic Fatigue Syndrome (pdf). Published: November 1, 2003. Investinme.org.