Modafinil for the Treatment of Fatigue in Primary Biliary Cirrhosis
Authors: Marshall M. Kaplan, Peter A.L. Bonis
Journal: Annals of Internal Medicine (2005)

Letters4 October 2005Modafinil for the Treatment of Fatigue in Primary Biliary CirrhosisMarshall M. Kaplan, MD and Peter A.L. Bonis, MDMarshall M. Kaplan, MDFrom Tufts-New England Medical Center, Boston, MA 02111.Search for more papers by this author and Peter A.L. Bonis, MDFrom Tufts-New England Medical Center, Boston, MA 02111.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-7-200510040-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Fatigue is common in patients with primary biliary cirrhosis and can occasionally be incapacitating (1-3). Although its cause is unknown, it may be related to dysfunction of either the corticotrophin-releasing hormone or serotonergic neurotransmitter systems (4). It does not correlate with the severity of the underlying liver disease, and there is no established treatment (1-3).Objective: Modafinil, a central nervous system stimulator, has been approved for treatment of narcolepsy and obstructive sleep apnea. Pilot studies have suggested that it may improve fatigue in several disorders, including multiple sclerosis, amyotrophic lateral sclerosis, HIV infection, and depression. These ...References1. Cauch-Dudek K, Abbey S, Stewart DE, Heathcote EJ. Fatigue in primary biliary cirrhosis. Gut. 1998;43:705-10. [PMID: 9824355] CrossrefMedlineGoogle Scholar2. Milkiewicz P, Heathcote EJ. Fatigue in chronic cholestasis. Gut. 2004;53:475-7. [PMID: 15016736] CrossrefMedlineGoogle Scholar3. Poupon RE, Chrétien Y, Chazouillères O, Poupon R, Chwalow J. Quality of life in patients with primary biliary cirrhosis. Hepatology. 2004;40:489-94. [PMID: 15368455] CrossrefMedlineGoogle Scholar4. Bergasa NV, Mason A, Floreani A, Heathcote J, Swain MG, Jones DE, et al. Primary biliary cirrhosis: report of a focus study group. Hepatology. 2004;40:1013-20. [PMID: 15382160] CrossrefMedlineGoogle Scholar5. Rosenberg JH, Shafor R. Fatigue in multiple sclerosis: a rational approach to evaluation and treatment. Curr Neurol Neurosci Rep. 2005;5:140-6. [PMID: 15743552] CrossrefMedlineGoogle Scholar6. Stankoff B, Waubant E, Confavreux C, Edan G, Debouverie M, Rumbach L, et al. Modafinil for fatigue in MS: a randomized placebo-controlled double-blind study. Neurology. 2005;64:1139-43. [PMID: 15824337] CrossrefMedlineGoogle Scholar7. DeBattista C, Doghramji K, Menza MA, Rosenthal MH, Fieve RR. Adjunct modafinil for the short-term treatment of fatigue and sleepiness in patients with major depressive disorder: a preliminary double-blind, placebo-controlled study. J Clin Psychiatry. 2003;64:1057-64. [PMID: 14628981] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Tufts-New England Medical Center, Boston, MA 02111.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byReview article: pathophysiology and management of primary biliary cholangitisPrimary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver DiseasesA Randomized, Placebo-Controlled Clinical Trial of Efficacy and Safety: Modafinil in the Treatment of Fatigue in Patients With Primary Biliary CirrhosisAutoimmune Liver Diseases: Primary Biliary CholangitisPrimary Biliary Cholangitis: Its Science and PracticeProposed therapies in primary biliary cholangitisEmerging drugs for the treatment of Primary Biliary CholangitisPrimary biliary cirrhosisTreatment of primary biliary cirrhosisRestless leg syndrome is a treatable cause of sleep disturbance and fatigue in primary biliary cirrhosisCirrosi biliare primitivaCentral nervous system dysfunction in primary biliary cirrhosis and its relationship to symptomsPrimary biliary cirrhosisPrimary biliary cirrhosis: A 2010 updateCirrhose biliaire primitiveCirrhose biliaire primitiveCirrosis biliar primariaModafinil in the Treatment of Debilitating Fatigue in Primary Biliary Cirrhosis: A Clinical ExperiencePrimary biliary cirrhosisFatigue in Primary Biliary CirrhosisAn integrated care pathway improves quality of life in Primary Biliary CirrhosisA Predictive Model for Fatigue and Its Etiologic Associations in Primary Biliary CirrhosisModafinil Treatment for Fatigue Associated with FibromyalgiaAn open study of modafinil for the treatment of daytime somnolence and fatigue in primary biliary cirrhosisFatigue in primary biliary cirrhosis is associated with excessive daytime somnolence 4 October 2005Volume 143, Issue 7Page: 546-547KeywordsColchicineFatigueLiver diseasesMethotrexateMultiple sclerosisNarcolepsyNeurotransmittersPilot studiesPrimary biliary cirrhosisSleep apnea ePublished: 4 October 2005 Issue Published: 4 October 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...