CNS Drugs

, Volume 32, Issue 1, pp 65–74 | Cite as

Fatigue in Patients with Major Depressive Disorder: Prevalence, Burden and Pharmacological Approaches to Management

  • Helia Ghanean
  • Amanda K. Ceniti
  • Sidney H. KennedyEmail author
Review Article


Fatigue is a frequently reported symptom in major depressive disorder, occurring in over 90% of patients. Clinical presentations of fatigue within major depressive disorder encompass overlapping physical, cognitive and emotional aspects. While this review addresses the epidemiology, burden, functional impact and management of fatigue in major depressive disorder, the main focus is on available pharmacotherapy options and their comparative efficacies. Our review of the effects of pharmacological treatments on fatigue in major depressive disorder found that medications with dopaminergic and/or noradrenergic action such as modafinil, flupenthixol and atomoxetine were most effective in improving symptoms of fatigue and low energy. However, significant variation across studies in assessment tools and study inclusion/exclusion criteria may have contributed to inconsistent findings. The efficacy of non-pharmacological interventions is also discussed, including light therapy and exercise.


Compliance with Ethical Standards


No funding was received for the preparation of this article.

Conflict of interest

Sidney H. Kennedy has received research funding or honoraria from the following sources: Abbott, Allergan, AstraZeneca, BMS, Brain Cells Inc., Brain Canada, Canadian Institutes for Health Research, Clera, Janssen, Lundbeck, Lundbeck Institute, Ontario Mental Health Foundation, Ontario Brain Institute, Ontario Research Fund, Otsuka, Pfizer, Servier, St. Jude Medical, Sunovion and Xian-Janssen. Helia Ghanean and Amanda K. Ceniti have no conflicts of interest directly relevant to the content of this article.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre for Mental HealthUniversity Health NetworkTorontoCanada
  2. 2.Institute of Medical ScienceUniversity of TorontoTorontoCanada
  3. 3.ASR Suicide and Depression Studies ProgramSt. Michael’s HospitalTorontoCanada
  4. 4.Department of PsychiatryUniversity of TorontoTorontoCanada
  5. 5.Krembil Research InstituteToronto Western HospitalTorontoCanada
  6. 6.Li Ka Shing Knowledge InstituteTorontoCanada

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