[Wakefulness-promoting agents for severe fatigue: to use or not to use?]

Autor: De Wit LE; St. Antonius Ziekenhuis, Nieuwegein en Utrecht. Afd. Psychiatrie.; Contact: le.de.wit@antoniusziekenhuis.nl., Vis R; St. Antonius Ziekenhuis, Nieuwegein en Utrecht. Afd. Klinische Farmacie., Teunissen LL; St. Antonius Ziekenhuis, Nieuwegein en Utrecht. Afd. Neurologie en Klinische Neurofysiologie.
Jazyk: Dutch; Flemish
Zdroj: Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2024 Apr 16; Vol. 168. Date of Electronic Publication: 2024 Apr 16.
Abstrakt: About 20% of adults experience excessive daytime sleepiness or severe fatigue. Causes include somatic conditions, psychiatric disorders, and medication or drug use. Treatment depends on the underlying cause. If sleepiness persists despite optimal treatment of the underlying condition, exclusion of other causes, and behavioral interventions, wakefulness-promoting agents may be considered. However, no established pharmacological strategy exists for symptomatic treatment. Modafinil and stimulants like methylphenidate may offer some benefit based on experiences with narcolepsy or idiopathic hypersomnia. Studies in specific patient groups (e.g., multiple sclerosis, Parkinson's disease, traumatic brain injury, cancer-related fatigue) show variable results. The use of wakefulness-promoting agents is discouraged for addressing unexplained fatigue, as seen in the context of chronic fatigue syndrome.
Databáze: MEDLINE