Conventional Medical Treatments for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

What is myalgic encephalomyelitis/chronic fatigue syndrome?

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a medical condition defined by persistent, severe fatigue that lasts for months or years. It can affect the ability to work, go to school, participate in social activities, and complete daily tasks, such as taking a shower or making a meal.

There is no cure for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). However, several conventional medical treatments are available that can help manage symptoms such as fatigue, sleep problems, and muscle pain. These treatment options include medications, psychotherapy, and physical therapy.

Medications

Several types of medications, including sleep medications, pain medications, stimulants, antidepressants, and medications for orthostatic intolerance, may help manage the varied symptoms of ME/CFS.

• Sleep medications
  A major symptom of ME/CFS is difficulty getting restful sleep, which increases fatigue. An over-the-counter (OTC) sleep aid, such as an antihistamine, may help. If an OTC sleep aid is not effective, a prescription sleep medication, such as eszopiclone or zolpidem, may be prescribed. However, it is important to note that prescription sleep medications frequently cause side effects like daytime sleepiness or dizziness. These medications also become less effective when used on a daily basis, so they are not intended for long-term use.
• Pain medications
  Over-the-counter pain medications, such as acetaminophen or ibuprofen, may help reduce headaches, muscle aches, and joint pain. Certain prescription medications, including pregabalin, duloxetine, gabapentin or amitriptyline, may also help reduce pain in some cases.
• Stimulants
  Stimulants commonly used to treat attention-deficit/hyperactivity disorder (ADHD) may help reduce fatigue and memory/concentration problems. However, these medications should be used with caution. They may create a burst of energy that causes overexertion which can then lead to post-exertional malaise. Repeating this cycle can worsen ME/CFS. Stimulants also have potential side effects such as irritation, weight loss, and insomnia.
• Antidepressants
  Some individuals with ME/CFS deal with depression. In these cases, antidepressants may make it easier to cope with ME/CFS. Antidepressants may also reduce pain and sleep difficulties.
• Medications for orthostatic intolerance
  If dizziness, feeling faint, or nausea are experienced when moving from a reclined position into sitting upright or standing, a medication to regulate blood pressure or heart rhythms may be beneficial. Examples include fludrocortisone, midodrine and propranolol.

Other treatments

Other conventional treatments for ME/CFS include psychotherapy, physical therapy, and compression stockings.

• Psychotherapy
  Talk therapy can help individuals learn to cope with ME/CFS. Psychotherapy can also help with depression management.
• Physical therapy
  Physical therapy can reduce muscle and joint pain. Trained physical therapists can also help individuals learn to stretch and move in ways that do not trigger PEM.
• Compression stockings
  If orthostatic intolerance is an issue, prescription compression or support stockings can reduce pooling of blood in the legs. This can help prevent symptoms like dizziness and faintness.