Neurological research · 2026
Efficacy and safety of modafinil in post-stroke fatigue: a systematic review and meta-analysis.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Simon Petry Iago Nathan, Caruso Novaes Tudella Gabriel, de Bastos Maximiano Mariana Letícia, Picanco Silva Yasmin, Pereira Gonzalez João Victor, Ramlow Leodoro da Silva Leonora, Ramlow Leodoro da Silva João Antônio, Gonçalves Camacho Giovanna Cristina, de Oliveira Machado Marcos, Soares Luis Gustavo Biondi, Fagundes Walter
Аннотация
PURPOSE OF THE RESEARCH: Post-stroke fatigue (PSF) is a common and disabling condition that limits rehabilitation and quality of life, yet no pharmacological treatment is well established. Modafinil, a wakefulness-promoting agent, has been proposed as a potential therapy. This systematic review and meta-analysis evaluated its efficacy and safety in PSF.
PRINCIPAL RESULTS: Four studies (two RCTs, two observational) comprising 1001 met inclusion criteria. Modafinil did not significantly improve overall fatigue severity on the MFI or FSS. A domain-specific benefit was observed for mental fatigue (MD -2.51; p = 0.0005), with no significant effects on physical, general, or activity-related fatigue. No improvements were found in quality of life (SSQoL) or cognition (MoCA). Modafinil was generally well tolerated with few mild adverse events.
MAJOR CONCLUSIONS: Current evidence does not support modafinil as a routine treatment for PSF. Its effect on mental fatigue is of very low certainty, limiting the strength of this finding. Clinicians should interpret these findings cautiously, and use modafinil only on a case-by-case basis. Larger, high-quality trials with standardized fatigue measures are needed to identify responders and clarify its clinical role.
PRINCIPAL RESULTS: Four studies (two RCTs, two observational) comprising 1001 met inclusion criteria. Modafinil did not significantly improve overall fatigue severity on the MFI or FSS. A domain-specific benefit was observed for mental fatigue (MD -2.51; p = 0.0005), with no significant effects on physical, general, or activity-related fatigue. No improvements were found in quality of life (SSQoL) or cognition (MoCA). Modafinil was generally well tolerated with few mild adverse events.
MAJOR CONCLUSIONS: Current evidence does not support modafinil as a routine treatment for PSF. Its effect on mental fatigue is of very low certainty, limiting the strength of this finding. Clinicians should interpret these findings cautiously, and use modafinil only on a case-by-case basis. Larger, high-quality trials with standardized fatigue measures are needed to identify responders and clarify its clinical role.