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Modafinil + paroxetine is a combination of two pharmaceutical agents: modafinil, a wakefulness-promoting agent, and paroxetine, a selective serotonin reuptake inhibitor (SSRI) antidepressant. This combination has been studied as an adjunctive therapy for major depressive disorder (MDD) with fatigue. Modafinil acts primarily by inhibiting dopamine reuptake and activating orexin neurons to promote wakefulness, while also affecting glutamatergic and GABAergic neurotransmission. Paroxetine increases serotonergic activity by inhibiting the presynaptic reuptake of serotonin via the sodium-dependent serotonin transporter, thereby increasing synaptic serotonin levels. The combination may enhance both the onset and degree of symptom improvement in MDD with fatigue compared to SSRI monotherapy[1][3]. Both drugs are small molecules approved individually for various indications.
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