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Recovery from refractory chronic fatigue syndrome with CBT and modafinil
  1. Himanshu Garg1,
  2. Maggie Douglas2,
  3. Gordon Douglas Turkington3 and
  4. Douglas Turkington3
  1. 1Adult Services, Bradford District Care NHS Foundation Trust, Bradford, UK
  2. 2Wolfson Research Centre, CNTW, Newcastle upon Tyne, UK
  3. 3Enhanced Bed Management, CNTW, Newcastle upon Tyne, UK
  1. Correspondence to Professor Douglas Turkington; Douglas.Turkington{at}


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.

  • psychiatry (drugs and medicines)
  • cognitive behavioural psychotherapy

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  • Contributors All authors: conception or design of the work; acquisition, analysis or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; and agreement to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.