RT Journal Article SR Electronic T1 Recovery from refractory chronic fatigue syndrome with CBT and modafinil JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e240283 DO 10.1136/bcr-2020-240283 VO 14 IS 3 A1 Himanshu Garg A1 Maggie Douglas A1 Gordon Douglas Turkington A1 Douglas Turkington YR 2021 UL http://casereports.bmj.com/content/14/3/e240283.abstract AB 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.