Hi Susan:

In my experience there are two different kinds of fatigue. The first is what I call "hit you over the head and put you to sleep" fatigue, and this is the fatigue that seems to be helped by meds such as Amatadine, Ritalin, and Provigil. It is this sort of fatigue that most PWMS seem to experience.

The second sort of fatigue is neurological muscular fatigue, which is closely related to weakness and has no element of sleepiness in it. This is the sort of fatigue that affects me. When I crash, it's difficult for me to even lift my elbows up to my WC's armrests, hold my head up, or accomplish a transfer from my WC to the couch. Sadly, no med I've ever taken for fatigue (and I've tried them all) touches this fatigue. The only thing that helps even a little is simply to remain still for several hours.

Chris