Karaş, Hakan, Kaşer, Muzaffer · Turk psikiyatri dergisi = Turkish journal of psychiatry · 2019
This case report describes one patient with depression who also had erectile dysfunction and fatigue. When the antidepressant fluoxetine alone did not fully help his symptoms, doctors added a stimulant medication called modafinil. After adding modafinil, the patient reported improvements in both his fatigue and erectile dysfunction alongside his mood symptoms.
ME/CFS patients frequently experience depression, sexual dysfunction, and severe fatigue, and antidepressants often fail to address the fatigue component. This case raises the hypothesis that modafinil's stimulant properties might help address fatigue and comorbid sexual dysfunction in ME/CFS patients, warranting further investigation in controlled trials.
This single case report cannot establish that modafinil is effective for treating fatigue or sexual dysfunction in ME/CFS or depression more broadly. It does not prove causality—improvements could reflect placebo effect, natural recovery, or the combined effect of both medications rather than modafinil alone. Generalization from one patient to broader populations is not possible.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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