Positives

• In an 8-week ME/CFS trial, patients on solriamfetol improved fatigue severity scores by about 2 points compared to 0.46 on placebo, with executive function and metacognition also improving SAGE Journals.
  
  
• One reviewer reported their daily 3-4 hour naps disappeared and constant yawning dropped about 90%, calling Sunosi life-changing without the crash they had on stimulants Drugs.com.
  
  

Negatives

• Across 87 reviews on Drugs.com solriamfetol averaged only 5.4/10, with 36% of patients describing a negative experience including headache, blood pressure rise, GI upset and a hard afternoon crash Drugs.com.
  
  
• A patient reported being awake but too fatigued to use the wakefulness, alongside anxiety, sweating, nausea and diarrhea after dose increases WebMD.
  
  

Hurdles & Side Effects

• Solriamfetol is FDA-approved only for narcolepsy and obstructive sleep apnea, so Long COVID patients pursuing it depend on off-label prescribing and inconsistent insurance coverage WebMD.
  
  
• A Long COVID patient hoping to qualify for solriamfetol through the RECOVER hypersomnia trial must travel to a study site and meet narrow inclusion criteria Science Translational Medicine.