The only two meds I've tried for fatigue were amantadine and provigil. Fail! I was allergic to the amantadine, and the provigil made me jittery and gave me nightmares. I decided I'd just use diet coke, save some money!

Others have tried different meds; perhaps someone will chime in?

One thing that frustrates me is the impossibility of determining whether a bout with severe fatigue is an exacerbation, a pseudo-exacerbation, or just a reaction to overdoing it. Or none of the above!

A period of 24 hours or more of SEVERE fatigue, separated from other episodes by at least 30 days, CAN be an actual exacerbation (otherwise known as relapse, attack, or flare-up). It CAN be, but that doesn't mean it is.

It can be a pseudo-exacerbation, or pseudo-flare--a temporary worsening of fatigue due to heat, illness, any number of things. OR....??

Every once in a while, like every year or two, I have a few days of extreme fatigue...I'm not usually sleepy, just tired, but during these spells I just can't get enough sleep, and can barely drag myself around. I guess it wouldn't change anything to know if they are technically flares.