Efficacy and safety of modafinil in post-stroke fatigue: a systematic review and meta-analysis

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.