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Pharmaceuticals

The list of pharmaceuticals prescribed for patients with ME/CFS is extensive, spanning a broad range of drugs – from over-the-counter medications, to narcotics and immune modulators.

The reason there is such a wide array is that treatments are aimed at both alleviating symptoms, which in ME/CFS are numerous, and at correcting secondary infections, which are found in the majority of ME/CFS patients. Physicians have found that by correcting secondary infections patients can make considerable improvement. Neither of these types of treatment directly addresses the immune system dysregulation that underlies the disease, however. (See Experimental Treatments.)

The mostly commonly prescribed medications for ME/CFS are antidepressants. In a recent survey on antidepressants conducted by ProHealth, of the 20 antidepressant medications listed, there wasn’t one that had not been tried by the respondents. In fact, each antidepressant listed had been taken by a significant portion of the respondents (range of 32% to 66%), with an average of 9 different prescription antidepressants per person.

A survey of over 4,000 ME/CFS patients conducted in Great Britain found that 35%- 40% of the respondents had taken antidepressants. The results of both surveys confirmed that while antidepressants were among the most commonly prescribed medications for ME/CFS, more than one-third of ME/CFS patients reported feeling worse after taking them.

Drugs aimed at symptom relief

Physicians who treat ME/CFS generally try to mitigate their patients’ most severe symptoms. Typically, they begin with sleep disorder, pain, orthostatic intolerance, and cognitive dysfunction. Some physicians treat cognitive problems with stimulants (e.g. Adderall), but most specialists recommend avoiding the use of stimulants because they cause an increase in fatigue.

Below are some prescription and over-the-counter drugs recommended by ME /CFS clinicians for four of the most commonly experienced symptoms. (In spite of the fact that all ME/CFS patients experience fatigue – of various sorts – there is no drug that will treat it. As Dr. Paul Cheney put it, “treating fatigue is treating the illness itself.”)

Note: Because patients with ME/CFS frequently have sensitivities and allergies, as well as paradoxical reactions to medications, all of these treatments must be supervised by a physician, regardless of whether a prescription is required. It is always best to begin with a very low dose.

Sleep medications

Over-the counter

Benadryl

Ibuprofen PM

Prescription

Ambien, Sonata, Restoril, Rozerem

Antidepressants (doxepin, trazodone, etc.)

Muscle relaxers (Flexeril)

Benzodiazepines (clonazepam)

Gabapentin

 

Pain medications

Over-the-counter

Tylenol

NSAIDs (Ibuprofen, etc.)

Prescription

Anticonvulsants (Topamax, Zonegran)

Narcotics (Demerol)

Nitroglycerin

 

Medications for Orthostatic Intolerance

Over-the-counter

Electrolyte solutions

Prescription

Florinef

Pyridostigmine

Beta-Blockers

 

Cognitive Dysfunction

Over-the-counter

Piracetam   

Prescription 

Calcium Channel Blockers

CNS Stimulants

Diamox                                              

 

Medications aimed at secondary infections

When it comes to treating ME/CFS, each doctor utilizes a different approach, depending on how they view the illness. Those physicians who prioritize treating secondary infections, such as Dr. Lucinda Bateman and Dr. Kenny De Meirleir, believe that concurrent infections must be eliminated in order to allow patients to recover. Treatments will depend on which secondary infections are found upon testing.

Some physicians have reported dramatic success treating patients who have ongoing secondary infections. Dr. Carol Jessop, an internist in California, suspected that candidiasis played a major role in the development of ME/CFS. Dr. Jessop treated yeast infections in thousands of patients with ME/CFS with antifungals combined with an anti-candida therapy program for 3-12 months. The majority of these patients experienced a significant reduction of symptoms. (CFIDS Chronicle, Spring 1991).

Physicians using antivirals have also reported success. In a recent study conducted by Dr. Dan Peterson on the antiviral, Vistide, seventy percent of the patients were able to return to work or had significant increases in functionality.

The most common medications prescribed for secondary infections are below.

Type of infection                                                               Treatment

Bacterial infection (Borrelia, mycoplasma)                 Antibiotics (wide-spectrum)

Candida, or yeast infection                                             Antifungals (Nystatin, Diflucan)

Viral reactivation                                                              Antivirals (valacyclovir, Vistide)

Parasites (giardia)                                                            Mebendazole and pyrantel pamoate

Small Intestine Bacterial Overgrowth                           Xifaxan

 

More information about pharmaceutical treatments

Chronic Pain Control Basics for ME/CFS and Fibromyalgia http://www.prohealth.com/library/showArticle.cfm?libid=16770

Report From Paris: Peterson Reports Antiviral (Vistide) Effective in Treating Herpesvirus Infected Chronic Fatigue Syndrome (ME/CFS) Patients

http://www.prohealth.com/library/showArticle.cfm?libid=17991&site=articles

Fighting Those Persistent Infections in CFIDS

http://www.cfids-cab.org/cfs-inform/Optimists/newsletter.teitelbaum01.htm