This report may be the first to describe a safe and effective combination of modafinil and an MAOI. There are some obvious limitations. The patient did not have a sleep study performed, so perhaps modafinil was treating an underlying sleep disorder, although no change in nighttime sleep was described. A placebo control would have been helpful, although years of taking other agents did not elicit this kind of response. Long-term safety cannot be guaranteed. Perhaps a drug interaction had not had time to develop, although usually this kind of adverse reaction can occur after as little as a single dose, and this individual had already taken hundreds of doses. Further study on the safety and usefulness of modafinil augmentation with MAOIs would be helpful. Despite these drawbacks, this case does suggest that some individuals taking MAOIs may be able to derive clinical benefit to manage the persistent fatigue and hypersomnolence that may occur during treatment of depressive disorders by adding modafinil.